The Value Of NLR And PLR In Judging The Condition And Prognosis Of Patients With Sepsis

Objective:To investigate the predictive effect of neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)on the condition and prognosis of patients with sepsis.Method:A retrospective analysis of sepsis patients admitted to the emergency intensive care unit of the First Affiliated Hospital of Nanchang University from December 2017 to November 2018.All patients were enrolled with venous blood or arterial blood as samples to determine the blood routine,blood biochemistry,coagulation function,blood gas analysis and other indicators.Collect basic clinical data of patients,perform SOFA score,APACHE II score,and calculate PLR and NLR values.Grouping method:1.According to whether there was septic shock,it was divided into sepsis group and septic shock group.2.According to the 28-day prognosis,it was divided into survival group and death group.Multivariate logistic regression analysis was used to assess the independent risk factors for the condition(whether combined with shock)and prognosis.The receiver operating characteristic curve(ROC curve)was used to evaluate the predictive value of PLR and NLR for the condition and prognosis of patients with sepsis.Results:1.The NLR of the sepsis group and the sepsis shock group were 12.49(7.12,18.34)vs.21.82(12.23,31.42)P=0.002,and the Procalcitonin(PCT)were 1.4(0.51,12.69)ng/L vs.9.73(2.61,20.55)ng/L P=0.002,platelet to neutrophil ratio(PNR)were 19.35(13.46,22.17)vs.12.36(5.33,18.57)P=0.002.Compared with sepsis,aspanate aminotransferas(AST),Conjudated bilirubin(CB),B-type natriuretic peptid(BNP),creatine kinase-MB(CK-MB),prothrombin time(PT),activated partial thromboplastin time(APTT),SOFA score and APACHE II scores were significantly higher in the septic shock group,and the difference was statistically significant(P<0.05);however platelet count were significantly lower,and the difference was statistically significant(P<0.05).Other indicators were not statistically different between the two groups..2.The NLR of the surviving group and the death group were 13.26(9.62,22.89)vs.23.38(16.75,29.18)P=0.021,PLR were 212.46±111.57 vs.334.75±157.87P=0.004,PCT were 2.42(0.81,10)ng/L vs.16.36(9.85,44.3)ng/L P = 0.000,Compared with the survival group,the age,Red blood cell distribution width coefficient of variation(RDW-CV),lactic acid,SOFA score,and APACHE II scores of the death group were higher,and the difference was statistically significant(P<0.05);body temperature,lymphocyte count,and oxygenation index were lower;and the difference between the two groups was statistically significant(P<0.05)。Other indicators were not statistically different between the two groups.3.PNR,SOFA score and AST were independent risk factors for septic shock in patients.4.Patient age,PCT and oxygenation index were independent risk factors for the prognosis of patients with sepsis.5.Patients with APACHE II score and SOFA score predicted the area under the ROC curve of patients with septic shock were 0.793 and 0.833.The area under the NLR combined with the PCT curve was 0.771,which was higher than the single index NLR(0.719)and PCT(0.716),suggesting that the combined index helps to improve the predictive value of septic shock in patients.6.Patient’s age,APACHE II score and SOFA score differentiated the area under the ROC curve of death and survival in patients with sepsis by 0.712,0.744,and0.663.The area under the PLR combined with the PCT curve was 0.899,which was higher than the single index PLR(0.730)and PCT(0.812);the area under the NLR combined PCT curve was 0.837,higher than NLR(0.676)and PCT(0.812).Conclusion:1.NLR has certain value in predicting patients with septic shock and prognosis.2.PLR has a certain value for the prognosis of patients with sepsis,but it is of little significance for predicting the occurrence of septic shock in patients.3.The combined index of NLR,PLR and PCT can improve the predictive valueof the condition and prognosis of patients with sepsis.