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评估C反应蛋白与中性粒细胞与淋巴细胞比值联合评分对急性胰腺炎器官衰竭的预测价值。

ASSESSING THE PREDICTIVE VALUE OF THE C-REACTIVE PROTEIN AND NEUTROPHIL-TO-LYMPHOCYTE RATIO COMBINED SCORE FOR ORGAN FAILURE IN ACUTE PANCREATITIS.

作者信息

Piñerúa-Gonsálvez Jean Félix, Ruiz-Rebollo María Lourdes, Fernández-Salazar Luis

机构信息

Department of Gastroenterology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.

出版信息

Arq Gastroenterol. 2025 Jun 16;62:e24119. doi: 10.1590/S0004-2803.24612024-119. eCollection 2025.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSION

The C-NLR score could be a useful supplementary tool for predicting organ failure in AP, complementing traditional scoring systems.

摘要

背景

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。

方法

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。

结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d432/12176416/2fd3288867b4/1678-4219-ag-62-e24119-gf1.jpg

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