血小板与淋巴细胞比值和单核细胞与淋巴细胞比值预测脓毒症患者发生急性肾损伤的价值

Predictive Value of Platelet-to-Lymphocyte Ratio and Monocyte-to-Lymphocyte Ratio in Acute Kidney Injury of Patients with Sepsis

摘要: 目的：探索血小板与淋巴细胞比值(PLR)和单核细胞与淋巴细胞比值(MLR)预测脓毒症患者发生急性肾损伤(AKI)的价值。方法：将221例脓毒症患者分为AKI组和非AKI组(N-AKI组)，对两组患者入院时的PLR、MLR和相关的临床指标进行统计分析；采用Spearman相关性分析对PLR、MLR与其他的临床指标进行相关性分析；采用Logistic回归模型及ROC曲线分析，探讨入院时PLR、MLR对脓毒症患者发生急性肾损伤的预测价值。结果：AKI组患者入院时的PLR、MLR均小于N-AKI组，差异有统计学意义(P < 0.001)；入院时的PLR、MLR与SOFA评分呈显著负相关(P < 0.05)；多因素Logistic回归分析显示PLR、MLR、动脉血乳酸、APACHEⅡ评分、SOFA评分均为脓毒症患者发生AKI的独立预测因素；PLR预测脓毒症患者发生AKI的AUC为0.646，最佳截断值为127.875，敏感度48.4%，特异性77%。MLR预测脓毒症患者发生AKI的AUC为0.638，最佳截断值为0.455，敏感度53.7%，特异性69.8%。结论：PLR、MLR可以作为预测脓毒症患者发生AKI的有效指标。

Abstract: Objective: To explore the value of platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) in predicting acute kidney injury (AKI) in patients with sepsis. Methods: 221 patients with sepsis were divided into AKI group and non-AKI group (N-AKI group). The PLR, MLR and related clinical indicators of the two groups at admission were statistically analyzed. Spearman correlation analysis was used to analyze the correlation between PLR, MLR and other clinical indicators. Logistic regression model and ROC curve analysis were both used to explore the predictive value of PLR and MLR on AKI in sepsis patients. Results: The PLR and MLR at admission in AKI group were lower than those in N-AKI group, the difference was statistically significant (P < 0.001); PLR and MLR at admission were significantly negatively correlated with SOFA score (P < 0.05); multivariate logistic regression analysis showed that PLR, MLR, arterial blood lactic acid, APACHEⅡscore, SOFA score were independent predictors of AKI in sepsis patients; PLR predicted AKI in sepsis patients. The AUC was 0.646, the best cutoff value was 127.875, the sensitivity was 48.4%, and the specificity was 77%. The AUC of MLR was 0.638, the best cut-off value was 0.455, the sensitivity was 53.7%, and the specificity was 69.8%. Conclusion: PLR and MLR can be used to predict AKI in patients with sepsis.