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血小板与淋巴细胞比值(PLR)和中性粒细胞与淋巴细胞比值(NLR)对儿科体外膜肺氧合(ECMO)结果有预测价值吗?

Do platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) have a predictive value on pediatric extracorporeal membrane oxygenation (ECMO) results?

机构信息

Pediatric Cardiovascular Surgery Department, Kartal Kosuyolu High Education and Training Hospital, Cevizli Kavşağı, Turkey.

Pediatric Cardiovascular Anesthesia and Reanimation Department, Kartal Kosuyolu High Education and Training Hospital, Cevizli Kavşağı, Turkey.

出版信息

Cardiol Young. 2021 Jun;31(6):1003-1008. doi: 10.1017/S1047951121001918. Epub 2021 May 21.

Abstract

BACKGROUND

It is difficult to predict the complications and prognosis of ECMO, which is gaining widespread use in patients with pediatric surgery. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are emerging inflammatory markers that can be calculated from complete blood count, which is a cheap and easily accessible laboratory analysis. The ratios between cellular elements in peripheral blood have been demonstrated to provide information on inflammation, infection, and immune response.

METHODS

Sixty-seven patients who needed ECMO application after undergoing pediatric cardiovascular surgery in our clinic, between May 2005 and April 2020, were included in this study. The age of patients varied between 4 days and 17 years with a mean of 30.59 ± 147.26 months.

RESULTS

The relationships between PLR or NLR values and various blood parameters and blood gas results were found to be statistically nonsignificant in our group of pediatric ECMO recipients. Even if the effect of PLR and NLR values on mortality and prognosis is statistically nonsignificant in patients who need ECMO after congenital heart surgery, PLR and NLR are typically elevated in the postoperative period. An increase in these values above a certain threshold may be a statistically significant indicator for the prediction of mortality.

CONCLUSIONS

There are few studies in the literature concerning PLR and NLR values in patients with pediatric heart surgery. We consider this study will make way for new studies in the future.

摘要

背景

在儿科外科患者中广泛应用的 ECMO 并发症和预后难以预测。血小板与淋巴细胞比值(PLR)和中性粒细胞与淋巴细胞比值(NLR)是新兴的炎症标志物,可从全血细胞计数中计算得出,这是一种廉价且易于获得的实验室分析。外周血中细胞成分的比值已被证明可以提供有关炎症、感染和免疫反应的信息。

方法

本研究纳入了 2005 年 5 月至 2020 年 4 月期间在我院接受儿科心血管手术后需要 ECMO 应用的 67 例患者。患者年龄为 4 天至 17 岁,平均 30.59±147.26 个月。

结果

在我们的儿科 ECMO 受者组中,PLR 或 NLR 值与各种血液参数和血气结果之间的关系没有统计学意义。即使 PLR 和 NLR 值对先天性心脏病手术后需要 ECMO 的患者的死亡率和预后没有统计学意义,但 PLR 和 NLR 通常在术后升高。这些值升高超过一定阈值可能是死亡率预测的统计学显著指标。

结论

关于儿科心脏手术患者的 PLR 和 NLR 值的文献研究很少。我们认为这项研究将为未来的新研究铺平道路。

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