Piñerúa-Gonsálvez Jean Félix, Ruiz-Rebollo María Lourdes, Fernández-Salazar Luis
Department of Gastroenterology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
Arq Gastroenterol. 2025 Jun 16;62:e24119. doi: 10.1590/S0004-2803.24612024-119. eCollection 2025.
Acute pancreatitis (AP) is a common gastrointestinal disorder, with organ failure being the primary cause of mortality. This study evaluates the combined score of C-reactive protein level and neutrophil-to-lymphocyte ratio (C-NLR score), as a predictor of organ failure.
A retrospective analysis was conducted on AP patients admitted to the Hospital Clínico Universitario de Valladolid between March 2014 and January 2022. The C-NLR score was calculated from admission data: patients with both elevated neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) were assigned a score of 2, those with one elevated marker received a score of 1, and a score of 0 was given to those with neither.
A total of 778 patients were included: 611 with mild AP (MAP), 123 with moderately severe AP (MSAP), and 44 with severe AP (SAP). A C-NLR score of 2 was most frequently observed in patients with MSAP (56.1%) and SAP (56.85%), while a score of 1 was more common in patients with MAP (46.9%). Multivariable logistic regression analysis revealed that a C-NLR score of 2 significantly increased the likelihood of organ failure by threefold (OR 3.176; 95% CI 1.297-7.775).
The C-NLR score could be a useful supplementary tool for predicting organ failure in AP, complementing traditional scoring systems.
急性胰腺炎（AP）是一种常见的胃肠道疾病，器官衰竭是主要的死亡原因。本研究评估C反应蛋白水平与中性粒细胞与淋巴细胞比值的综合评分（C-NLR评分）作为器官衰竭的预测指标。
对2014年3月至2022年1月在巴利亚多利德大学临床医院收治的AP患者进行回顾性分析。根据入院数据计算C-NLR评分：中性粒细胞与淋巴细胞比值（NLR）和C反应蛋白（CRP）均升高的患者评分为2分，仅有一项指标升高的患者评分为1分，两项指标均未升高的患者评分为0分。
共纳入778例患者：611例为轻症急性胰腺炎（MAP），123例为中度重症急性胰腺炎（MSAP），44例为重症急性胰腺炎（SAP）。MSAP患者（56.1%）和SAP患者（56.85%）中最常观察到C-NLR评分为2分，而MAP患者中评分为1分更为常见（46.9%）。多变量逻辑回归分析显示，C-NLR评分为2分显著增加器官衰竭的可能性达三倍（OR 3.176；95%CI 1.297-7.775）。
C-NLR评分可能是预测AP患者器官衰竭的有用补充工具，可补充传统评分系统。
