NLR、PLR、RDW在感染性休克诊断、监测及预后评估中的应用*

doi:10.3969/j.issn.1671-2587.2018.01.027

临床输血与检验 ›› 2018, Vol. 20 ›› Issue (1): 79-82.DOI: 10.3969/j.issn.1671-2587.2018.01.027

NLR、PLR、RDW在感染性休克诊断、监测及预后评估中的应用^*

陈伟, 刘艳, 刘金菊, 戴小辉, 肖小红, 肖扬

417000 湖南省娄底市中心医院（陈伟,刘金菊,戴小辉,肖小红,肖扬）, 湖南省娄底市妇幼保健院/儿童医院（刘艳）

收稿日期:2017-06-30 出版日期:2018-02-20 发布日期:2018-02-28
通讯作者: 肖扬,男,主要从事骨科临床工作,（E-mail）xiao_yang168@sina.com。
作者简介:陈伟（1983-）,男,湖南湘潭人,主管检验师,硕士,主要从事分子免疫和感染免疫工作,（Tel）15576356510。
基金资助:
*本课题受中央引导地方科技发展专项（No.2017CT5028）、娄底市科技创新计划项目（No.LDKJ201706）资助

Clinical Application of NLR,PLR and RDW to Diagnosis,Monitoring and Prognosis of Septic Shock

CHEN Wei, TAN Hua-qing, LIU Jin-ju, et al

Loudi Center Hospital of Hunan,Hunan Loudi,417000

Received:2017-06-30 Online:2018-02-20 Published:2018-02-28

摘要/Abstract

摘要： 目的研究中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）及红细胞分布宽度（RDW）,在感染性休克的诊断、动态监测及预后评估中的临床意义。方法选择感染性休克患者155例（其中死亡组76例、治愈组79例）,同期以健康体检人群155例作为阴性对照组。比较病例组与对照组在降钙素原（procalcitonin,PCT）、WBC、RDW、PLR及NLR之间的差异,分析各指标对感染性休克的诊断效率及其与PCT的相关性。比较死亡组与治愈组之间的差异,分析各指标与患者结局的相关性。结果 PCT、WBC、RDW、PLR、NLR在病例组与对照组比较差异均有统计学意义,NLR以4.68为诊断临界值,诊断灵敏度和特异度分别为96.1% 和95.5%。PLR以14.62为诊断临界值,诊断灵敏度和特异度分别为72.3% 和66.4%。PCT与NLR、PLR呈正相关（r=0.884,0.599）。感染性休克病例组中死亡率为49.03%,死亡组与治愈组比较PCT、RDW有差异。患者结局与PCT、RDW呈负相关（r=-0.165,-0.449）。不同时间段患者的PCT、WBC、PLR、NLR有差异,且PCT与NLR、PLR在不同时间段有明显相关性。结论 NLR、PLR与PCT呈明显正相关,可用于辅助诊断及动态监测感染性休克患者,RDW与患者结局呈明显负相关,对患者预后评估有一定的临床意义。

关键词: 感染性休克, 降钙素原, 中性粒细胞/淋巴细胞比值, 血小板/淋巴细胞比值, 红细胞分布宽度

Abstract: Objective To study clinical significance of NLR,PLR and RDW in the diagnosis,dynamic monitoring and prognosis of septic shock. Methods One hundred and fifty-five cases of septic shock（group death：76 deaths,cured group：79 cases）and 155 cases of healthy control were subjected to NLR,PLR and RDW blood testing. A comparison was made in PCT,WBC,RDW,PLR and NLR for their efficiency in diagnosis of septic shock. Results PCT,WBC,RDW,PLR and NLR tests in cases group revealed a statistical significance. The diagnostic sensitivity and specificity were 96.1% and 95.5%,respectively when 4.68 was taken as NLR diagnosis threshold,and 72.3% and 66.4%,respectively when 14.62 was used as PLR threshold. PCT had significantly positive correlation with NLR and PLR（r=0.884,0.599）. The mortality of septic shock was 49.03%. A difference was seen between PCT and RDW in deaths and cured individuals. Patient outcome had positive correlation with PCT and RDW（r=-0.165,-0.449）.Conclusion NLR and PLR had positive correlation with PCT,that can be used to for diagnosis and dynamic monitoring in septic shock patients due to their convenience,economy,and easy application.

Key words: Septic shock, Procalcitonin, Neutroplhil to lymphocyte ratio, Platelet to lymphocyte ratio, Red blood cell distribution width

中图分类号:

R631⁺.4

陈伟, 刘艳, 刘金菊, 戴小辉, 肖小红, 肖扬. NLR、PLR、RDW在感染性休克诊断、监测及预后评估中的应用^*[J]. 临床输血与检验, 2018, 20(1): 79-82.

CHEN Wei, TAN Hua-qing, LIU Jin-ju, et al. Clinical Application of NLR,PLR and RDW to Diagnosis,Monitoring and Prognosis of Septic Shock[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2018, 20(1): 79-82.

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NLR、PLR、RDW在感染性休克诊断、监测及预后评估中的应用^*

Clinical Application of NLR,PLR and RDW to Diagnosis,Monitoring and Prognosis of Septic Shock

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