摘要
目的探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、单核细胞与淋巴细胞比值(MLR)及抗凝血酶Ⅲ(ATⅢ)对高脂血症性急性胰腺炎(HLAP)诊断及病情评估的临床意义。方法回顾性收集2021年2月至2022年12月于福建省立医院住院治疗的67例HLAP患者作为观察组,收集同期65例非HLAP患者作为对照组。分析NLR、PLR、MLR及ATⅢ与三酰甘油(TG)、总胆固醇(TC)之间的相关性;利用受试者工作特征(ROC)曲线评估NLR、PLR、MLR及ATⅢ对HLAP的诊断价值,将观察组患者按修订版亚特兰大分级标准分为轻症(22例)、中重症(16例)、重症(29例)三组,分析NLR、PLR、MLR及ATⅢ与HLAP病情严重程度的关系。结果两组患者的NLR、PLR、MLR及ATⅢ比较,差异无统计学意义(P>0.05);观察组患者的TC、TG水平高于对照组,差异有统计学意义(P<0.05)。Spearman相关性分析显示,MLR与TC呈正相关(r=0.647,P<0.05);MLR与ATⅢ呈负相关(r=-0.617,P<0.05);ATⅢ与TC呈负相关(r=-0.427,P<0.05)。ROC曲线分析显示,NLR、PLR、MLR、ATⅢ四项指标单项及联合检测诊断HLAP的曲线下面积(AUC)分别为0.931、0.534、0.805、0.308、0.959;其中NLR最优,敏感度为75.81%,特异度为99.82%;四项联合诊断的AUC优于各项单独诊断,敏感度为84.76%,特异度为99.81%。重症组患者的NLR、PLR、MLR水平高于轻症组,ATⅢ水平低于轻症组,差异有统计学意义(P<0.05);中重症组患者的NLR、PLR、MLR水平高于轻症组,差异有统计学意义(P<0.05)。Spearman相关性分析显示,NLR、MLR与病情严重程度呈正相关(r=0.518、0.272,P<0.05),ATⅢ与病情严重程度呈负相关(r=-0.139,P<0.05)。结论NLR、PLR、MLR及ATⅢ联合对诊断HLAP有较大价值,NLR、MLR、ATⅢ对于评估HLAP病情严重程度有较大临床意义。
Objective To explore the clinical significance of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),monocytes to lymphocyte ratio(MLR)and antithrombinⅢ(ATⅢ)in the diagnosis and evaluation of hyperlipidemic acute pancreatitis(HLAP).Methods Retrospective collection of 67 HLAP patients hospitalized at Fujian Provincial Hospital from February 2021 to December 2022 were selected as the observation group,and 65 non HLAP patients were selected as the control group during the same period.The correlation among NLR,PLR,MLR and ATⅢwith triglyceride(TG)and total cholesterol(TC)was analyzed.The diagnostic value of NLR,PLR,MLR and ATⅢwere evaluated in HLAP using the receiver operating characteristic(ROC)curve,the observation group patients were divided into three groups according to revised Atlanta classification standards,mild(22 cases),moderate to severe(16 cases)and severe(29 cases),the relationship among NLR,PLR,MLR and ATⅢof the severity condition in HLAP was analyzed.Results There were no statistically significant differences in NLR,PLR,MLR,and ATⅢbetween the two groups of patients(P>0.05).The levels of TC and TG in the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed a positive correlation between MLR and TC(r=0.647,P<0.05).MLR was negatively correlated with ATⅢ(r=-0.617,P<0.05).There was a negative correlation between ATⅢand TC(r=-0.427,P<0.05).ROC curve analysis showed that the area under the curve(AUC)of NLR,PLR,MLR and ATⅢfor single and combined detection and diagnosis of HLAP were 0.931,0.534,0.805,0.308 and 0.959,respectively.Among them,NLR was the best,with a sensitivity of 75.81%and a specificity of 99.82%.The AUC of four combined diagnoses was superior to each individual diagnosis,with a sensitivity of 84.76%and a specificity of 99.81%.The levels of NLR,PLR and MLR in the severe group were higher than those in the mild group,while the levels of ATⅢwas lower than that in the mild group,with statistical significances(P<0.05).The NLR,PLR and MLR levels of patients in the moderate to severe group were higher than those in the mild group,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that NLR and MLR were positively correlated with disease severity(r=0.518,0.272,P<0.05),while ATⅢwas negatively correlated with disease severity(r=-0.139,P<0.05).Conclusion The combination of NLR,PLR,MLR and ATⅢhas great value in diagnosing HLAP,NLR,MLR and ATⅢhave significant clinical significance in evaluating the severity of HLAP.
作者
杨杭妹
YANG Hangmei(The Second Department of Critical Care Medicine,Fujian Provincial Hospital,Fujian Province,Fuzhou350001,China)
出处
《中国当代医药》
CAS
2023年第27期8-12,F0003,共6页
China Modern Medicine
基金
福建省自然科学基金资助项目(2022J01404)。
