血小板-淋巴细胞比率及其动态变化预测了感染性急性损伤患者的死亡率:使用美国数据库和中国医院数据的回顾性多中心研究
Caihong Liu1, Xue Tang2, Wei Wei1
1Department of Nephrology, Institute of Kidney Diseases, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
PeerJ
|January 12, 2026
概括
血小板与淋巴细胞比率 (PLR) 的升高预测了感染性急性损伤 (AKI) 的死亡率. 动态PLR变化也表明生存结果,有助于危急病患者的风险分层.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
背景情况:
- 血小板与淋巴细胞比率 (PLR) 是重症监护中的一个具有成本效益的预后生物标志物.
- 它在预测败血性急性损伤 (AKI) 的结果中的作用还不清楚.
- 住院PLR轨迹对生存的影响在很大程度上是未知的.
研究的目的:
- 为了研究基线和动态PLR在败血症AKI患者的预后效用.
- 评估PLR及其变化 (ΔPLR) 与死亡率和住院时间之间的关联.
- 探索PLR与结果关系中的潜在调解因素.
主要方法:
- 对MIMIC-IV和西中国医院数据的回顾性分析.
- 生存分析和Cox比例危险模型来评估PLR和ΔPLR与28天和90天死亡率的关联.
- 进行了内部和外部验证,子组分析和调解分析.
主要成果:
- 升高的基线PLR (≥335.44) 与明显更高的28天和90天死亡率有关.
- 较低的 ΔPLR 也预测死亡率增加和住院时间延长,在验证队列中得到证实.
- 在非尿路感染患者中,预后值显著;低基线PLR受益于男性患者. 白细胞计数的变化调解了 ΔPLR 对死亡率的影响.
结论:
- 基线PLR及其在医院的动态都是性AKI死亡率的显著预测因素.
- 基于PLR的指数可以提高风险分层和早期识别高风险患者.
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