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奥野预后营养指数和中性粒细胞与淋巴细胞比值在克罗恩病术后并发症风险评估中的应用。

Application of the Onodera prognostic nutrition index and neutrophil-to-lymphocyte ratio in risk evaluation of postoperative complications in Crohn's disease.

机构信息

Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.

出版信息

Sci Rep. 2017 Aug 16;7(1):8481. doi: 10.1038/s41598-017-09265-3.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5634/5559450/3bc450a84d13/41598_2017_9265_Fig1_HTML.jpg

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