血细胞指数在肺栓塞的预后价值
Fakiha Siddiqui1,2, Alfonso Tafur3,4, Mushtaq Hussain5
1Department of Pathology and Laboratory Medicine, Health Sciences Division, Cardiovascular Research Institute, Loyola University Chicago, Maywood, Illinois, USA.
American journal of hematology
|May 31, 2024
概括
中性粒细胞与淋巴细胞的比率 (NLR) 显著预测肺栓塞 (PE) 患者的30天死亡率. 较高的NLR提高了风险分层,特别是用于识别非常低风险的PE病例.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 临界护理医学 临界护理医学
背景情况:
- 在急性肺栓塞 (PE) 中,准确的预后对于患者的管理至关重要.
- 细胞指数如中性粒细胞与淋巴细胞比率 (NLR),血小板与淋巴细胞比率 (PLR) 和全身免疫炎症指数 (SII) 显示出作为预后标记物的潜力.
- 这些指数在不同PE队列中需要进一步验证.
研究的目的:
- 评估NLR,PLR和SII在预测急性PE患者30天全因死亡率方面的预后价值.
- 将这些细胞指数的预测性能与已建立的简化肺栓塞严重性指数 (sPESI) 进行比较.
- 评估NLR在完善PE患者的风险分层中的实用性,特别是那些风险较低的患者.
主要方法:
- 从RIETE注册 (10,085名患者) 和洛约拉大学医学中心 (LUMC) 队列 (700名患者) 的数据分析.
- 使用后勤回归模型来评估NLR,PLR,SII和30天死亡率之间的关联.
- 使用c统计数据对预后性能进行比较,并评估特定子组的灵敏度和负预测值.
主要成果:
- 升高的NLR (>7.0) 与30天死亡率的增加独立相关 (aOR:3.46),表现优于升高的PLR和SII.
- 与PLR和SII相比,NLR在不同风险层预测死亡率方面显示出更高的c-统计.
- 在sPESI得分为0的正常血压患者中,与NLR ≤7.0相结合,与单独使用sPESI相比,显著改善了30天死亡率的敏感性和负预测值.
结论:
- 中性粒细胞与淋巴细胞的比率 (NLR) 是急性PE30天死亡率的重要和独立的预后标志物.
- 与PLR和SII相比,NLR提供了优越的预后性能,并且在与sPESI一起使用时增强了风险分层.
- 对于识别PE患者,其30天死亡风险非常低的NLR特别有价值.
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