探讨NLR与SIRI术后与术前比值对经内镜逆行胰胆管造影术后急性胰腺炎的预测价值
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南京医科大学第二附属医院消化医学中心

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Title: Predictive Value of Postoperative/Preoperative NLR and SIRI Ratios for Post-ERCP PancreatitisZijun Zhao*,Yingting Zhu,Lin Miao
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    摘要:

    [目的]评估胆总管结石患者术前中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、术后NLR、术后与术前NLR比值、术前全身炎症反应指数(systemic inflammatory response index,SIRI)、术后SIRI、术后与术前SIRI比值对于内镜下逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)后并发急性胰腺炎(post-ERCP pancreatitis,PEP)的预测价值。[方法]收集549例行ERCP的胆总管结石患者的术前及术后血常规、ERCP术中操作、患者基本信息及既往病史等资料,分为PEP组(n=43)和无PEP组(n=506),比较两组之间术前、术后NLR、SIRI水平差异,计算术后与术前NLR及SIRI比值,比较两组之间水平差异,并通过受试者工作特征曲线(receiver operating characteristic,ROC)曲线分析各指标对于PEP的预测价值。[结果] PEP组与无PEP组相比,术前NLR、术后NLR、术前SIRI、术后SIRI,术后/术前NLR、术后/术前SIRI差异均有统计学意义(P<0.05),其中ERCP术后/术前NLR、术后/术前SIRI指标ROC曲线下面积均高于0.800,术后/术前SIRI较其他指标具有更高的敏感度95.35%和特异度70.24%。[结论]术后/术前NLR比值、术后/术前SIRI比值对于预测PEP具有参考价值。

    Abstract:

    [Objective] This study evaluated the correlation between acute pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP) and preoperative neutrophil to lymphocyte ratio(NLR),postoperative NLR,postoperative NLR,the ratio of postoperative to preoperative NLR,preoperative systemic inflammatory response index(SIRI),postoperative SIRI,the ratio of postoperative to preoperative SIRI.[Method] This retrospective study included 549 patients with common bile duct stones who underwent ERCP at our hospital from January 2021 to December 2023. The patients were divided into the post-ERCP pancreatitis(PEP) group(n=43) and non-PEP group(n=506).Relevant laboratory indicators, intraoperative ERCP procedures,basic patient information,and past medical history were collected. Differences in NLR and SIRI levels between these two groups were compared.Receiver operating characteristic(ROC) curve was used to assess the predictive value of each indicator for PEP.[Results] Among these indicators, the areas under the ROC curve (AUC) of the ratio of postoperative to preoperative NLR and the ratio of postoperative to preoperative SIRI after ERCP were both higher than 0.800. Specifically, the ratio of postoperative to preoperative SIRI exhibited a higher sensitivity (95.35%) and specificity (70.24%) than the other indicators.[Conclusions]The postoperative/preoperative NLR ratio and postoperative/preoperative SIRI ratio can be used as prognostic indicators of PEP.

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  • 收稿日期:2026-01-20
  • 最后修改日期:2026-04-02
  • 录用日期:2026-05-07
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