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中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值是急性肠系膜动脉栓塞和血栓形成患者预后的有效预测指标。

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Are Effective Predictors of Prognosis in Patients with Acute Mesenteric Arterial Embolism and Thrombosis.

作者信息

Wang Shuai, Liu Han, Wang Qi, Cheng Zhihua, Sun Siqiao, Zhang Yang, Sun Xiwei, Wang Zhongying, Ren Liqun

机构信息

Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Science, Jilin University, Changchun, Jilin, China; Department of Vascular Surgery, The First Hospital of Jilin University, Changchun, Jilin, China.

Department of Respiration, The First Hospital of Jilin University, Changchun, Jilin, China.

出版信息

Ann Vasc Surg. 2018 May;49:115-122. doi: 10.1016/j.avsg.2018.01.059. Epub 2018 Feb 9.

Abstract

BACKGROUND

The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been shown to be valuable prognostic markers for a variety of pathological conditions including solid tumors, sepsis, and others. However, the prognostic values of the NLR and PLR in patients with acute mesenteric arterial embolism (AMAE) and acute mesenteric arterial thrombosis (AMAT) have not been elucidated. The aim of this study was to determine the predictive value of the NLR and PLR for poor prognosis in patients with AMAE and AMAT.

METHODS

A total of 137 patients with AMAE (n = 77) or AMAT (n = 60) were divided into a poor outcome group (cases of intestinal necrosis or death) and a better outcome group (cases without intestinal necrosis who survived successfully), according to prognosis. Neutrophil, platelet, and lymphocyte counts were recorded before pharmacotherapy or surgery. The NLR and PLR were calculated, and logistic regression analysis was performed to test their prognostic values.

RESULTS

The cutoff values for NLR and PLR were 11.05 and 156.26, respectively. The PLR was linearly associated with the NLR (R = 0.769, P < 0.001). NLR (odds ratio [OR] = 6.835, 95% confidence interval [CI] = 2.282-20.469, P = 0.001), PLR (OR = 4.871, 95% CI = 1.627-14.587, P = 0.005), and coronary heart disease (OR = 3.388, 95% CI = 1.156-9.929, P = 0.026) were found to be independent prognostic factors for the patients.

CONCLUSIONS

NLR ≥ 11.05, PLR ≥ 156.26, and coronary heart disease were shown to be risk factors for poor prognosis in patients with AMAE and AMAT. According to these factors, patients can be divided into 3 prognostic groups: good, NLR < 11.05 with PLR < 156.26; moderate, NLR < 11.05 with PLR ≥ 156.26 or NLR ≥ 11.05 with PLR < 156.26; and poor, NLR ≥ 11.05 with PLR ≥ 156.26.

摘要

背景

中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)已被证明是包括实体瘤、脓毒症等多种病理状况的有价值的预后标志物。然而,NLR和PLR在急性肠系膜动脉栓塞(AMAE)和急性肠系膜动脉血栓形成(AMAT)患者中的预后价值尚未阐明。本研究的目的是确定NLR和PLR对AMAE和AMAT患者预后不良的预测价值。

方法

根据预后情况,将总共137例AMAE患者(n = 77)或AMAT患者(n = 60)分为预后不良组(肠坏死或死亡病例)和预后较好组(未发生肠坏死且成功存活的病例)。在药物治疗或手术前记录中性粒细胞、血小板和淋巴细胞计数。计算NLR和PLR,并进行逻辑回归分析以检验其预后价值。

结果

NLR和PLR的截断值分别为11.05和156.26。PLR与NLR呈线性相关(R = 0.769,P < 0.001)。发现NLR(比值比[OR] = 6.835,95%置信区间[CI] = 2.282 - 20.469,P = 0.0

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