Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Sci Rep. 2017 Aug 16;7(1):8481. doi: 10.1038/s41598-017-09265-3.
This study aimed to investigate application of Onodera prognostic nutrition index (OPNI) and neutrophil-to-lymphocyte ratio (NLR) in evaluating risk of postoperative complications in Crohn's disease (CD). Clinical data of 108 postoperative CD patients in 9 years were respectively reviewed. OPNI and NLR were within 1 week preoperatively. Average OPNI was 38.8 ± 8.2 and significantly lower in patients with: CD type B3; lymphopenia; decreased haemoglobin, prealbumin, and albumin; and daily enteral nutrition <500 kcal/d. Average NLR was 5.9 ± 12.1 and significantly higher in patients with: CD type B3, neutrophilia, lymphopenia, decreased prealbumin, and enteral nutrition <500 kcal/d. Youden index was maximal at OPNI 39.8 and NLR 4.1, patients were divided into two groups by OPNI 39.8 and NLR 4.1; Low OPNI (≤39.8) group had significantly greater incidence of type B3, lymphopenia, decreased haemoglobin, prealbumin and albumin, and enteral nutrition <500 kcal/day, more likely to have intra-abdominal bleeding. High NLR group (≥4.1) had significantly greater incidence of type B3, neutrophilia, and lymphopenia, more likely to develop lung infection. OPNI and NLR were significantly negatively correlated. Smoking within 1 year preoperatively, OPNI <39.8, NLR ≥ 4.1 were independent risk factors for postoperative complications in CD.
本研究旨在探讨小野预后营养指数(OPNI)和中性粒细胞与淋巴细胞比值(NLR)在评估克罗恩病(CD)术后并发症风险中的应用。回顾了 9 年内 108 例术后 CD 患者的临床资料。分别在术前 1 周内检测 OPNI 和 NLR。平均 OPNI 为 38.8±8.2,在以下患者中显著降低:CD 类型 B3;淋巴细胞减少;血红蛋白、前白蛋白和白蛋白减少;每日肠内营养<500kcal/d。平均 NLR 为 5.9±12.1,在以下患者中显著升高:CD 类型 B3、中性粒细胞增多、淋巴细胞减少、前白蛋白减少和肠内营养<500kcal/d。OPNI 为 39.8,NLR 为 4.1 时约登指数最大,将患者分为 OPNI 39.8 和 NLR 4.1 两组;低 OPNI(≤39.8)组 CD 类型 B3、淋巴细胞减少、血红蛋白、前白蛋白和白蛋白减少以及肠内营养<500kcal/d 的发生率显著更高,更易发生腹腔内出血。高 NLR 组(≥4.1)CD 类型 B3、中性粒细胞增多和淋巴细胞减少的发生率显著更高,更易发生肺部感染。OPNI 和 NLR 呈显著负相关。术前 1 年内吸烟、OPNI<39.8、NLR≥4.1 是 CD 术后并发症的独立危险因素。