术前中性粒细胞与淋巴细胞比值与胆囊炎病理分型的相关性

发布时间：2018-03-09 22:13

  本文选题：术前　切入点：中性粒细胞与淋巴细胞比值　出处：《延边大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的探讨术前中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)与胆囊炎病理分型的关系,为临床术前预测胆囊炎严重程度提供新的指标。方法收集2014年9月到2016年12月间在我院肝胆胰外科行胆囊切除并术后病理证实为胆囊炎患者346例,将胆囊炎患者分为单纯性胆囊炎组(A1组)、重症胆囊炎组(A2组)包括:穿孔性胆囊炎、坏疽性胆囊炎、黄色肉芽肿性胆囊炎;选择同期健康成人体检者50例作为对照组(B组),检测各组患者术前血常规指标,计算NLR比值,分析NLR与胆囊炎病理类型的相关性。结果346例中A1组246例(71.1%)和A2组100例(28.9%)。A组患者NLR的ROC曲线下面积(AUC)0.758,95%CI 0.373-0.771,约登指数取最大时cut-off=2.4561,灵敏度68.9%,特异性76.3%,明显高于B组(P0.0001);A1 组的 ROC 的 AUC 为 0.723,95%CI 0-0.661,约登指数取最大时 cut-off=2.2122,灵敏性 50.8%,特异性 92.0%。A2 组 NLR 的 ROC AUC 为 0.794,95%CI 0.746-0.842,约登指数取最大时cut-off=2.700,灵敏度87%,特异性60.6%,两者之间有统计学差异(P0.0001)。NLR≥2.7时预测重症胆囊炎的敏感性为87%和特异性为60.6%。多因素分析发现术前NLR≥2.7(比值比:1.793,95%可信区间:1.236-2.798,P0.0001)年龄51.23 岁(比值比[OR]:2.234,95%可信区间[CI]:1.249-3.417,P0.0001)及急诊入院(比值比:0.005,95%可信区间:1.171-2.597,P=0.362)与住院时间延长相关。结论 1.术前NLR可作为预测胆囊炎病理分型的指标;2.NLR≥2.7、患者年龄及急诊入院是住院时间延长的相关因素。
[Abstract]:Objective to investigate the relationship between the ratio of neutrophil to lymphocyte and the pathological type of cholecystitis before operation. Methods from September 2014 to December 2016, 346 patients with cholecystitis were treated by cholecystectomy in our hospital and proved to be cholecystitis by pathology. The patients with cholecystitis were divided into simple cholecystitis group A 1 group and severe cholecystitis group A 2) including perforated cholecystitis gangrene cholecystitis and xanthogranulomatous cholecystitis. In the same period, 50 healthy adults were selected as control group B, the preoperative blood routine indexes of each group were detected, and the NLR ratio was calculated. Results the correlation between NLR and pathological types of cholecystitis was analyzed. Results the area under the ROC curve of NLR in A 1 group and A 2 group was 0.75895 CI 0.373-0.771.Results in 346 cases, there were 246 cases in A1 group and 100 cases in A2 group. The area under the ROC curve was 0.75895 CI 0.373-0.771.The maximum value of Yoten index was cut-off 2.4561, sensitivity 68.9, specificity 76.3b, which was significantly higher than that in group B P0.0001C 1. The AUC of ROC was 0.72395 CI 0-0.661, the maximum value of Yorden index was 2.2122, the sensitivity was 50.8, the ROC AUC of group A 2 was 0.79495 CI 0.746-0.842, the maximum value of Yorden index was 0.79495 CI 0.746-0.842, the maximum value of Yorden index was 0.79495 CI 0.746-0.842, the maximum value of Yorden index was 0.79495 CI 0.746-0.842. There was a statistical difference between the two groups (P 0.0001nLR 鈮，

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