中性粒细胞与淋巴细胞比值作为内镜下腐蚀性损伤的预测因子

S. Uyar, M. Kok
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引用次数: 1

摘要

背景:内窥镜下损伤程度是进一步处理腐蚀性摄入的主要发现。然而,如果不能快速进行内镜检查,临床医生根据患者的体征和症状决定治疗和随访目标。本研究的目的是确定白细胞(WBC)、c反应蛋白(CRP)和中性粒细胞-淋巴细胞比率(NLR)与损伤程度的关系,并评估NLR是否能够预测损伤的严重程度。材料与方法:回顾性分析190例患者,平均年龄38.6岁。从医院档案中检索所有入院患者的白细胞、中性粒细胞、淋巴细胞和CRP值以及内镜检查结果。评估WBC、NLR、CRP与内镜检查结果之间的关系。结果:119例患者中有28例(23.5%)内镜检查正常,大多数患者(42例(35.3%))仅胃受累。损伤患者NLR明显高于正常患者(p=0.010),而WBC和CRP无显著差异。与无脏器受累的患者相比,同时有食道和胃损伤的患者NLR也明显更高(p<0.001)。NLR、WBC、CRP与受累程度呈弱相关。在ROC分析中,AUC值为0.914 (95% CI (0.85-0.96, p<0.001), NLR的临界值为8.71,区分0-1-2和3-4级损伤的敏感性为90%,特异性为91.7%。结论:较高的NLR值表明广泛和严重的腐蚀性摄入。NLR似乎也是区分严重和轻度损伤的更可靠的方法。它是一种容易得到且价格低廉的炎症标记物,可以指导急诊科内镜评估前的患者管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neutrophil to Lymphocyte Ratio as a Predictor of Endoscopic Damage in CausticInjuries
Context: The endoscopic degree of injuries is the main finding for further management of caustic ingestions. However, if endoscopy cannot be performed quickly, clinicians decide on treatment and follow-up goals according to the signs and symptoms of the patient. The aim of this study was to determine the association of white blood cells (WBC), C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR) with the degree of caustic injury and to evaluate whether NLR is able to predict the severity of injuries. Materials and methods: A retrospective evaluation was made of a total of 190 patients with a mean age of 38.6 years. WBC, neutrophil, lymphocyte and CRP values and endoscopic findings of all patients at hospital admission were retrieved from hospital files. The association between WBC, NLR, CRP and endoscopic findings was evaluated. Results: Endoscopy was normal in 28 of 119 patients (23.5%) and most patients (42 of 119 (35.3%) had only gastric involvement. NLR was significantly higher in patients with injuries than normal patients (p=0.010), whereas WBC and CRP not. NLR was also significantly higher in patients with both esophagus and gastric injuries compared to patients with no organ involvement (p<0.001). NLR, WBC and CRP were weakly correlated to the grade of involvement. In the ROC analysis, the AUC value was 0.914 (95% CI (0.85-0.96, p<0.001)) and the cut-off value for NLR was 8.71 with sensitivity of 90% and specificity of 91.7% for discriminating injuries as grade 0-1-2 from 3-4. Conclusions: Higher NLR values showed widespread and severe involvement of caustic ingestion. NLR also seems to be a more reliable method to make a distinction between severe and mild injuries. It is an easily derived and inexpensive marker of inflammation and might guide the management of patients before endoscopic evaluation in emergency departments.
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