Page 76 - 南京医科大学自然版

南京医科大学学报（自然科学版） 第44卷第12期
·1690 · Journal of Nanjing Medical University（Natural Sciences） 2024年12月

·临床研究·

中性粒细胞与淋巴细胞比值早期预测急性胆源性胰腺炎严重

程度和胰腺坏死的价值

沈佳庆，刘晓琳，顾慧媛 *

苏州大学附属第一医院消化内科，江苏 苏州 215006

［摘 要］ 目的：评估中性粒细胞与淋巴细胞比值（neutrophil to lymphocyte ratio，NLR）对急性胆源性胰腺炎（acute biliary pan⁃
creatitis，ABP）严重程度和胰腺坏死（pancreatic necrosis，PN）的预测价值。方法：纳入290例ABP患者并在急性胰腺炎发作24 h
内收集血液样本用于血常规及相关生化指标检测。通过受试者工作特性（receiver operating characteristic，ROC）曲线分析确定
NLR预测重症急性胰腺炎（severe acute pancreatitis，SAP）和PN的最佳临界值。采用不同浓度牛磺胆酸钠溶液诱导大鼠ABP模
型，并在造模后1、3、5、7、14 d收集血液和胰腺组织，比较各组的NLR。结果：ROC曲线分析显示NLR对SAP具有预测性能［曲
线下面积（area under curve，AUC）：0.944，95%可信区间（confidence interval，CI）：0.915~0.973，P < 0.001］，最佳临界值为 13.38
（灵敏度80.0%、特异度83.2%）。NLR 对PN 也有较好的预测价值，AUC 为0.910（95%CI：0.861~0.958，P < 0.001），诊断的最佳
临界值为9.265（灵敏度97.1%、特异度72.7%）。在大鼠ABP模型中，NLR在AP发病早期即可升高，并与AP和PN的严重程度
相关。结论：在ABP发病后的24 h内，NLR可以作为早期预测其严重程度及 PN的有力指标。
［关键词］ 急性胆源性胰腺炎；中性粒细胞与淋巴细胞比值；严重程度；胰腺坏死；动物模型
［中图分类号］ R576 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）12⁃1690⁃07
doi：10.7655/NYDXBNSN231053

The value of neutrophil to lymphocyte ratio in predicting the severity of acute biliary

pancreatitis and pancreatic necrosis
SHEN Jiaqing，LIU Xiaolin，GU Huiyuan *
Department of Gastroenterology，the First Affiliated Hospital of Soochow University，Suzhou 215006，China

［Abstract］ Objective：This study aimed to assess the value of neutrophil to lymphocyte ratio（NLR）in predicting the severity of
acute biliary pancreatitis（ABP）and pancreatic necrosis（PN）. Methods：A total of 290 ABP patients were included in this study. The
blood samples were collected for examination of blood routine and related biochemical indicators within 24 hours after onset of acute
pancreatitis. The optimal cut⁃off value for NLR to predict severe acute pancreatitis（SAP）and PN was determined by receiver operating
characteristic（ROC）curve analysis. ABP model was induced by taurocholic acid sodium in rats，and the blood and pancreatic tissue
were collected in 1，3，5，7，14 days after modeling to compare the NLR among groups. Results：ROC curve showed that NLR had a
predictive performance for SAP［area under the curve（AUC）：0.944，95%CI：0.915-0.973，P < 0.001］，the optimal cut⁃off from ROC
curve was 13.38（sensitivity：80.0%；specificity：83.2%）. For the prediction of PN，the AUC of NLR was 0.910（95%CI：0.861-0.958，
P < 0.001），the cut⁃off value was 9.265（sensitivity：97.1%；specificity：72.7%）. In ABP rats，NLR increases in the early stages of AP
and is correlated with the severity of AP and PN. Conclusion：Within 24 h after the onset of ABP，NLR can be used as a powerful for
early prediction of its severity and PN.
［Key words］ acute biliary pancreatitis；neutrophil to lymphocyte ratio；severity；pancreatic necrosis；animal model
［J Nanjing Med Univ，2024，44（12）：1690⁃1695，1707］

［基金项目］ 国家自然科学基金（81900508）
∗
通信作者（Corresponding author），E⁃mail：guhuiyuan@suda.edu.cn