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目的评价中性粒细胞/淋巴细胞比值(NLR)对多器官功能障碍综合征(MODS)发生的预测作用。方法将197例多发伤病患者按是否发生MODS分为MODS组44例和非MODS组153例。比较2组患者的临床资料、术前术后NLR值和NLR差值(δNLR)。用单因素和多因素分析确定MODS的危险因素。用ROC曲线确定δNLR的最佳诊断值,并比较2组患者的生存曲线。结果多发伤患者的δNLR、合并休克及APACHE III评分被确定为MODS发生的独立危险因素。δNLR的最佳诊断值为0.22,当患者δNLR>0.22比患者δNLR≤0.22明显更容易发生MODS或者MODS相关死亡(P<0.05)。结论δNLR是多发伤患者发生MODS的独立危险因素,当患者δNLR>0.22时更容易发生MODS。
Objective To evaluate the predictive value of neutrophil / lymphocyte ratio (NLR) on the occurrence of multiple organ dysfunction syndrome (MODS). Methods A total of 197 patients with multiple injuries were divided into MODS group (n = 44) and non-MODS group (n = 153) according to whether MODS occurred or not. The clinical data, preoperative and postoperative NLR and NLR difference (δNLR) were compared between the two groups. Risk factors for MODS were determined by univariate and multivariate analyzes. The best diagnostic value of δNLR was determined by ROC curve and the survival curves of two groups were compared. Results The results of δNLR, combined shock and APACHE III scores in multiple trauma patients were identified as independent risk factors for MODS. The optimal diagnostic value of δNLR was 0.22, which was significantly more likely to be associated with MODS or MODS-related death (P <0.05) when the patient had a δNLR> 0.22 greater than δNLR≤0.22. Conclusion δNLR is an independent risk factor for MODS in patients with multiple trauma. MODS is more likely to occur in patients with δNLR> 0.22.