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血小板与淋巴细胞比值、中性粒细胞与淋巴细胞比值与肺血栓栓塞症患者血栓负荷及疾病严重程度的相关性

Correlation between Platelet-to-Lymphocyte Ratio, Neutrophil-to-Lymphocyte Ratio and Burden of Thrombus with Disease Severity in Patients with Pulmonary Thromboembolism.

作者信息

Mammadova Ayshan, Taşkaraca Kübra, Jeyranova Günel, Orujlu Aysel, Tatlılıoğlu Merve, Duygulu Serra, Yalçınkaya Zeynep, Allahverdiyeva Seriyye, Gündoğdu Onur, Kılıç Atiye Cenay Karabörk, Özbek Sevcihan Kesen, Erbaş Gonca, Oğuzülgen I Kıvılcım

机构信息

Department of Chest Diseases, Lokman Hekim University Akay Hospital, Çankaya, Ankara, Turkey.

Department of Chest Diseases, Gazi University Faculty of Medicine, Ankara, Turkey.

出版信息

Hamostaseologie. 2025 Mar 28. doi: 10.1055/a-2506-6705.

Abstract

High neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of subclinical inflammation and have been associated with prognosis and mortality in many diseases. In this study, we evaluated the comparative value of NLR and PLR in identifying high mortality risk in patients hospitalized with acute pulmonary thromboembolism (PTE), and their relationship with the anatomical burden of thrombus.Patients who were followed up due to PTE were evaluated retrospectively. NLR and PLR were calculated from complete blood counts. The thrombus burden was assessed by the Qanadli score; based on the patients' archival computed tomography angiography images. Mortality prediction was based on an algorithm using the Pulmonary Embolism Severity Index, echocardiographic findings, and troponin levels.Three hundred-two PTE patients were included in the study. Median NLR, PLR, and Qanadli score values were higher in nonsurvivors, with NLR (8.4 [2.2-18.9]) vs. (3.1 [0.4-13.1]), PLR (317 [87.6-525.3]) vs. (124.4 [30-476.3]), and Qanadli scores (21 [3-26]) vs. (9 [1-28]), respectively ( < 0.001). We showed that setting a threshold value of >4.45 for NLR and >151.59 for PLR significantly predicts the high mortality-risk group. In the receiver operating characteristic analysis, when the threshold value for the Qanadli score distinguishing between low-risk and high-risk disease was set at 15.5, the sensitivity was calculated as 98.8% and the specificity was 94.9% ( = 0.001).This study showed that NLR, PLR, and Qanadli scores can provide essential contributions to the clinician's determination of the anatomical burden of thrombus and disease severity in PTE patients.

摘要

高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)是亚临床炎症的标志物,并且与许多疾病的预后和死亡率相关。在本研究中,我们评估了NLR和PLR在识别急性肺血栓栓塞症(PTE)住院患者高死亡风险中的比较价值,以及它们与血栓解剖负荷的关系。

对因PTE接受随访的患者进行回顾性评估。根据全血细胞计数计算NLR和PLR。通过Qanadli评分评估血栓负荷;基于患者的存档计算机断层扫描血管造影图像。死亡率预测基于使用肺栓塞严重程度指数、超声心动图检查结果和肌钙蛋白水平的算法。

302例PTE患者纳入本研究。非幸存者的NLR、PLR和Qanadli评分中位数较高,NLR分别为(8.4[2.2 - 18.9])对比(3.1[0.4 - 13.1]),PLR分别为(317[87.6 - 525.3])对比(124.4[30 - 476.3]),Qanadli评分分别为(21[3 - 26])对比(9[1 - 28])(<0.001)。我们表明,将NLR的阈值设定为>4.45以及将PLR的阈值设定为>151.59可显著预测高死亡风险组。在受试者工作特征分析中,当区分低风险和高风险疾病的Qanadli评分阈值设定为15.5时,敏感性计算为98.8%,特异性为94.9%(=0.001)。

本研究表明,NLR、PLR和Qanadli评分可为临床医生确定PTE患者的血栓解剖负荷和疾病严重程度提供重要帮助。

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