Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Department of Gastroenterology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
Sci Rep. 2017 Sep 6;7(1):10704. doi: 10.1038/s41598-017-10516-6.
It is important to identify the patients with high-risk progression to develop severe acute pancreatitis (SAP). The study was to assess whether neutrophil to lymphocyte ratio (NLR) and fluid sequestration (FS) could represent useful markers for predicting the severity. A total of 1639 patients who underwent clinical diagnosis of AP was performed. Various serologic and clinical parameters on admission were investigated. Chronologic change in NLR and FS were analyzed, and theirs utility for predicting severity of AP was evaluated by receiver operator characteristic (ROC) curve analysis. Correlation analysis was assessed by Spearman's rank test. NLR and FS levels were both increased significantly in SAP and positively correlated with Ranson score and hospital stays. The ROC curve analyses showed the optimal cut-off values of NLR for admission with day0, day1, day2 were 9.64, 6.66 and 6.50, giving sensitivity of 77-82%. The optimal cut-off values of FS for admission with day1, day2, day3 were 1375 ml, 2345 ml and 3424 ml, giving sensitivity of 62-75%. Moreover, measurement of NLR and FS together exhibited a similar area under curve (AUC) and sensitivity for SAP prediction compared with the those of Ranson score. Increase of NLR and FS are correlated with severity and can be suggested as a predictive factor in an early stage of AP.
确定具有发展为重症急性胰腺炎（SAP）高风险进展的患者很重要。本研究旨在评估中性粒细胞与淋巴细胞比值（NLR）和液体隔离（FS）是否可作为预测严重程度的有用标志物。对 1639 名经临床诊断为 AP 的患者进行了研究。入院时对各种血清学和临床参数进行了调查。分析了 NLR 和 FS 的时间变化，并通过接收者操作特征（ROC）曲线分析评估了它们预测 AP 严重程度的效用。通过 Spearman 等级检验评估相关性分析。SAP 中 NLR 和 FS 水平均显著升高，与 Ranson 评分和住院时间呈正相关。ROC 曲线分析显示入院时 NLR 的最佳截断值为 0 天、1 天、2 天分别为 9.64、6.66 和 6.50，敏感性为 77-82%。FS 的最佳截断值为入院第 1 天、第 2 天和第 3 天分别为 1375 ml、2345 ml 和 3424 ml，敏感性为 62-75%。此外，与 Ranson 评分相比，NLR 和 FS 的联合测量对 SAP 预测的 AUC 和敏感性相似。NLR 和 FS 的增加与严重程度相关，可作为 AP 早期的预测因子。
