本文選題：術(shù)前　切入點：中性粒細(xì)胞與淋巴細(xì)胞比值　出處：《延邊大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討術(shù)前中性粒細(xì)胞與淋巴細(xì)胞比值(neutrophil to lymphocyte ratio,NLR)與膽囊炎病理分型的關(guān)系,為臨床術(shù)前預(yù)測膽囊炎嚴(yán)重程度提供新的指標(biāo)。方法收集2014年9月到2016年12月間在我院肝膽胰外科行膽囊切除并術(shù)后病理證實為膽囊炎患者346例,將膽囊炎患者分為單純性膽囊炎組(A1組)、重癥膽囊炎組(A2組)包括:穿孔性膽囊炎、壞疽性膽囊炎、黃色肉芽腫性膽囊炎;選擇同期健康成人體檢者50例作為對照組(B組),檢測各組患者術(shù)前血常規(guī)指標(biāo),計算NLR比值,分析NLR與膽囊炎病理類型的相關(guān)性。結(jié)果346例中A1組246例(71.1%)和A2組100例(28.9%)。A組患者NLR的ROC曲線下面積(AUC)0.758,95%CI 0.373-0.771,約登指數(shù)取最大時cut-off=2.4561,靈敏度68.9%,特異性76.3%,明顯高于B組(P0.0001);A1 組的 ROC 的 AUC 為 0.723,95%CI 0-0.661,約登指數(shù)取最大時 cut-off=2.2122,靈敏性 50.8%,特異性 92.0%。A2 組 NLR 的 ROC AUC 為 0.794,95%CI 0.746-0.842,約登指數(shù)取最大時cut-off=2.700,靈敏度87%,特異性60.6%,兩者之間有統(tǒng)計學(xué)差異(P0.0001)。NLR≥2.7時預(yù)測重癥膽囊炎的敏感性為87%和特異性為60.6%。多因素分析發(fā)現(xiàn)術(shù)前NLR≥2.7(比值比:1.793,95%可信區(qū)間:1.236-2.798,P0.0001)年齡51.23 歲(比值比[OR]:2.234,95%可信區(qū)間[CI]:1.249-3.417,P0.0001)及急診入院(比值比:0.005,95%可信區(qū)間:1.171-2.597,P=0.362)與住院時間延長相關(guān)。結(jié)論 1.術(shù)前NLR可作為預(yù)測膽囊炎病理分型的指標(biāo);2.NLR≥2.7、患者年齡及急診入院是住院時間延長的相關(guān)因素。
[Abstract]:Objective to investigate the relationship between the ratio of neutrophil to lymphocyte and the pathological type of cholecystitis before operation. Methods from September 2014 to December 2016, 346 patients with cholecystitis were treated by cholecystectomy in our hospital and proved to be cholecystitis by pathology. The patients with cholecystitis were divided into simple cholecystitis group A 1 group and severe cholecystitis group A 2) including perforated cholecystitis gangrene cholecystitis and xanthogranulomatous cholecystitis. In the same period, 50 healthy adults were selected as control group B, the preoperative blood routine indexes of each group were detected, and the NLR ratio was calculated. Results the correlation between NLR and pathological types of cholecystitis was analyzed. Results the area under the ROC curve of NLR in A 1 group and A 2 group was 0.75895 CI 0.373-0.771.Results in 346 cases, there were 246 cases in A1 group and 100 cases in A2 group. The area under the ROC curve was 0.75895 CI 0.373-0.771.The maximum value of Yoten index was cut-off 2.4561, sensitivity 68.9, specificity 76.3b, which was significantly higher than that in group B P0.0001C 1. The AUC of ROC was 0.72395 CI 0-0.661, the maximum value of Yorden index was 2.2122, the sensitivity was 50.8, the ROC AUC of group A 2 was 0.79495 CI 0.746-0.842, the maximum value of Yorden index was 0.79495 CI 0.746-0.842, the maximum value of Yorden index was 0.79495 CI 0.746-0.842, the maximum value of Yorden index was 0.79495 CI 0.746-0.842. There was a statistical difference between the two groups (P 0.0001nLR 鈮，

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