NLR、血清总胆红素和钠联合检测对急性阑尾炎严重程度的预测价值

目的探讨中性粒细胞与淋巴细胞比值(NLR)、血清总胆红素(TBIL)和钠(Na)对急性阑尾炎严重程度的预测价值。方法选取2018年10月至2021年2月在皖西卫生职业学院附属医院住院并行阑尾切除术的271例急性阑尾炎患者为研究对象。根据术后病理诊断将患者分为单纯性阑尾炎组(228例)和复杂性阑尾炎组(43例),比较2组患者的临床资料和各项检测指标。采用多因素Logistic回归模型分析复杂性阑尾炎的危险因素,采用受试者工作特征(ROC)曲线分析NLR、血清TBIL和Na单独及联合检测对复杂性阑尾炎的预测价值。结果复杂性阑尾炎组的术前体温、白细胞计数、中性粒细胞计数、单核细胞与淋巴细胞比值、血小板与淋巴细胞比值、NLR及血清TBIL、直接胆红素、间接胆红素水平均高于单纯性阑尾炎组(P<0.05),而淋巴细胞计数和血清Na水平均低于单纯性阑尾炎组(P<0.05)。多因素Logistic回归模型分析显示,NLR、血清TBIL和Na是复杂性阑尾炎的独立危险因素(OR=1.225、0.487、1.296,P<0.05)。Pearson相关分析显示,急性阑尾炎患者NLR、血清TBIL水平均与血清Na呈负相关(r=-0.255、-0.207,P<0.05),NLR与血清TBIL无相关性(r=0.076,P>0.05)。ROC曲线分析显示,NLR+TBIL+Na联合检测预测复杂性阑尾炎的曲线下面积为0.954,高于TBIL、Na、NLR单独检测的0.777、0.789、0.799(P<0.05);NLR+TBIL+Na联合检测预测复杂性阑尾炎的特异度和灵敏度分别为82.50%和95.30%。结论NLR、TBIL和Na是复杂性阑尾炎的独立危险因素,三者联合检测对复杂性阑尾炎具有较好的预测价值。

Predictive value of combined detection of NLR,serum total bilirubin and sodium in the severity of acute appendicitis

Objective To investigate the predictive value of neutrophil to lymphocyte ratio(NLR),serum total bilirubin(TBIL)and sodium(Na)on the severity of acute appendicitis.Methods A total of 271 patients with acute appendicitis who were hospitalized and undergone appendectomy in the Affiliated Hospital of West Anhui Health Vocational College from October 2018 to February 2021 were selected as the research objects.According to postoperative pathological diagnosis,the patients were divided into simple appendicitis group(228 cases)and complicated appendicitis group(43 cases),and the clinical data and various detection indexes of the two groups were compared.Multivariate Logistic regression model was used to analyze the risk factors of complicated appendicitis,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of NLR,serum TBIL,and Na alone and combination detection in complicated appendicitis.Results The preoperative body temperature,white blood cell count,neutrophil count,monocyte to lymphocyte ratio,platelet to lymphocyte ratio,NLR and the serum levels of TBIL,direct bilirubin and indirect bilirubin in the complicated appendicitis group were higher than those in the simple appendicitis group(P<0.05),and the lymphocyte count and serum Na level were lower than those in the simple appendicitis group(P<0.05).Multivariate Logistic regression model analysis showed that NLR,TBIL and Na were independent risk factors for complicated appendicitis(OR=1.225,0.487,1.296,P<0.05).Pearson correlation analysis showed that NLR and serum TBIL level in patients with acute appendicitis were negatively correlated with serum Na(r=-0.255,-0.207,P<0.05),and there was no correlation between NLR and serum TBIL(r=0.076,P>0.05).ROC curve analysis showed that the combined detection of NLR+TBIL+Na predicted that the area under the ROC curve of complicated appendicitis was 0.954,which was higher than 0.777,0.789,0.799 detected by TBIL,Na and NLR alone(P<0.05);the specificity and sensitivity of NLR+TBIL+Na combined detection for predicting complicated appendicitis were 82.50%and 95.30%,respectively.Conclusion NLR,TBIL and Na are independent risk factors for complicated appendicitis,and the combined detection of the three has good predictive value for complicated appendicitis.