Clinical value of the ratio of neutrophils to lymphocytes in predicting the severity of acute pancreatitis
LIU Wei1 LU Hongjuan2 KONG Lele1 FAN Xiaoxia1 ZHONG Renqian1 ZHOU Lin1
1.Department of Laboratory Diagnostics, Changzheng Hospital Affiliated to the Second Military Medical University, Shanghai 200003, China;
2.Department of Rheumatology, Changzheng Hospital Affiliated to the Second Military Medical University, Shanghai 200003, China
Abstract：Objective To investigate the value of peripheral blood neutrophil/lymphocyte ratio (NLR) in predicting the severity of acute pancreatitis (AP). Methods A retrospective analysis was performed on the clinical data of 114 AP patients admitted to the Changzheng Hospital Affiliated to the Second Military Medical University from January 2015 to June 2017, 94 healthy volunteers were selected as the control group and 114 patients as the AP group. Blood routine, liver and kidney function, and electrolyte indexes were compared between the two groups. According to the new classification standard of Atlanta, AP patients were divided into three groups, mild (MAP), moderate (MSAP) and severe (SAP). Spearman rank correlation was used to compare the correlation between NLR and serum creatinine and calcium ion level, and the diagnostic value of NLR, serum creatinine and calcium ion in SAP was further compared by ROC curve. Results Compared with healthy control group, NLR and serum creatinine were significantly increased in AP group (all P ＜ 0.05). There was a correlation between NLR and AP severity (P ＜ 0.05), positive correlation with serum creatinine (r = 0.191, P ＜ 0.05), and negatively correlated with calcium ions (r = -0.244, P ＜ 0.01). The area under the curve of NLR diagnosis of SAP was 0.81 (95%CI: 0.703-0.924), and the difference was not statistically significant compared with serum creatinine and calcium ions (all P ＞ 0.05). Conclusion NLR has certain clinical significance in predicting the severity of AP.
刘魏1 卢红娟2 孔乐乐1 樊笑霞1 仲人前1 周琳1. 中性粒细胞与淋巴细胞比值预测急性胰腺炎严重程度的临床价值[J]. 中国医药导报, 2019, 16(13): 159-162.
LIU Wei1 LU Hongjuan2 KONG Lele1 FAN Xiaoxia1 ZHONG Renqian1 ZHOU Lin1. Clinical value of the ratio of neutrophils to lymphocytes in predicting the severity of acute pancreatitis. 中国医药导报, 2019, 16(13): 159-162.
[1] 中华医学会消化病学分会胰腺疾病学组.中国急性胰腺炎诊治指南（2013年，上海）[J].中华消化杂志，2013，33（4）：217-222.
[2] Bugiantella W，Rondelli F，Boni M，et al. Necrotizing pancreatitis：a review of the interventions [J]. Int J Surg 2016， 28（Suppl 1）：S163-S171.
[3] Azab B，Jaglall N，Atallah JP，et al. Neutrophil-lymphocyte ratio as a predictor of adverse outcomes of acute pancreatitis [J]. Pancreatology，2011，11（4）：445-452.
[4] Tenner S，Baillie J，Dewitt J，et al. American College of Gastroenterology guideline：management of acute pancreatitis [J]. Am J Gastroenterology，2013，108（9）：1400-1415.
[5] Banks PA，Bollen TL，Dervenis C，et al. Classification of acute pancreatitis-2012：revision of the Atlanta classification and definitions by international consensus [J]. Gut，2013，62（1）：102-111.
[6] Shrivastava P，Bhatia M. Essential role of monocytes and macrophages in the progression of acute pancreatitis [J]. World J Gastroenterology，2010，16（32）：3995-4002.
[7] Gomez D，Farid S，Malik HZ，et al. Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative resection for hepatocellular carcinoma [J]. World J Surg，2008，32（8）：1757-1762.
[8] Sharaiha RZ，Halazun KJ，Mirza F，et al. Elevated preoperative neutrophil：lymphocyte ratio as a predictor of postoperative disease recurrence in esophageal cancer [J]. Ann Surg Oncol，2011，18（12）：3362-3369.
[9] Gibson PH，Croal BL，Cuthbertson BH，et al. Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting [J]. American Heart J，2007，154（5）995-1002.
[10] Walsh SR，Cook EJ，Goulder F，et al. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer [J]. J Surg Oncol 2005，91（3）：181-184.
[11] Wittel UA，Rau B，Gansauge F，et al. Influence of PMN leukocyte-mediated pancreatic damage on the systemic immune response in severe acute pancreatitis in rats [J]. Dig Dis Sci，2004（7/8）：1348-1357.
[12] Suppiah A，Malde D，Arab T，et al. The prognostic value of the neutrophil-lymphocyte ratio（NLR） in acute pancreatitis：identificationof an optimal NLR [J]. J Gastrointest Surg 2013，17（4）：675-681.
[13] Yang ZW，Meng XX，Xu P，et al. Central role of neutrophil in the pathogenesis of severe acute panereatitis [J]. J Cell Mol Med，2015，19（11）：2513-2520.
[14] Malmateom ML，Hansen MB，Andersen AM，et al. Cytokine and organ failure in acute pancreatitis：inflammatory response in acute pancreatitis [J]. Pancreas，2012（2）：271-277.
[15] Takeyama Y，Takas K，Ueda T，et al. Peripheral lymphocyte reduction in severe acute pancreatitis is caused by apoptotic cell death [J]. J Gastrointest Surg，2000，7/8（4）：379-387.
[16] 钟斌.血肌酐水平与早期急性重症胰腺炎患者预后的相关性[J].现代消化及介入诊疗，2016，21（1）：50-53.
[17] 彭春燕，韩真.C反应蛋白、血钙和胸腔积液对急性胰腺炎早期预后的评估[J].皖南医学院学报，2013，32（3）：213-214.
[18] 胡秦妮，张玉琴，邓芝云，等.中性粒细胞与淋巴细胞比值预测急性胰腺炎严重程度的意义[J].国际检验医学杂志，2013，34（23）：3119-3121.
[19] 周天昀，潘婷婷，刘嘉琳，等.中性粒细胞与淋巴细胞比值在亚特兰大新分类标准下预测急性胰腺炎严重程度的价值[J].上海交通大学学报：医学版，2016，36（7）：1023-1028.
[20] 余贤恩.中性粒细胞与淋巴细胞比值对急性胰腺炎严重性的预测价值[J].胃肠病学和肝病学杂志，2012，21（6）：574-577.
2019, Vol. 16 
京公网安备 11010502046598号