Page 63 - 南京医科大学自然版

第46卷第5期 南京医科大学学报（自然科学版）
2026年5月 Journal of Nanjing Medical University（Natural Sciences） ·685 ·

·临床研究·

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

赵子君，朱颖婷，缪 林 *

南京医科大学第二附属医院消化医学中心，江苏 南京 210011

［摘 要］ 目的：评估并对比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，比较两组间差异，并通过受试者工作特征（receiver operating characteristic，ROC）曲线分析各指标对 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
的灵敏度（95.3%）和特异度（70.2%）。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。
［关键词］ 急性胰腺炎；经内镜逆行胰胆管造影术；中性粒细胞与淋巴细胞比值；全身炎症反应指数
［中图分类号］ R576 ［文献标志码］ A ［文章编号］ 1007⁃4368（2026）05⁃685⁃06
doi：10.7655/NYDXBNSN260099

Predictive value of postoperative to preoperative ratios of NLR and SIRI for acute
pancreatitis after endoscopic retrograde cholangiopancreatography
*
ZHAO Zijun，ZHU Yingting，MIAO Lin
Department of Gastroenterology，the Second Affiliated Hospital of Nanjing Medical University，Nanjing 210011，China

［Abstract］ Objective：To evaluate and compare the predictive values of preoperative neutrophil to lymphocyte ratio（NLR），
postoperative NLR，postoperative/preoperative NLR ratio，preoperative systemic inflammatory response index（SIRI），postoperative
SIRI，and postoperative/preoperative SIRI ratio for post⁃endoscopic retrograde cholangiopancreatography（ERCP）pancreatitis（PEP）in
patients with choledocholithiasis. Method：Clinical data including preoperative and postoperative blood routine results，intraoperative
ERCP conditions，basic information and medical history of 549 patients with choledocholithiasis undergoing ERCP were collected. The
patients were divided into the PEP group（n=43）and the non⁃PEP group（n=506）. The levels of NLR and SIRI before and after ERCP
were compared between the two groups，the postoperative to preoperative ratios of NLR and SIRI were calculated，the differences in
levels of these indicators between the two groups were compared，and the receiver operating characteristic（ROC）curve was used to
analyze the predictive value of each indicator for PEP. Results：Significant differences were observed between the PEP group and the
non⁃PEP group in preoperative NLR，postoperative NLR，preoperative SIRI，postoperative SIRI，postoperative/preoperative NLR ratio
and postoperative/preoperative SIRI ratio（all P < 0.05）. The areas under the ROC curve（AUC）of postoperative/preoperative NLR ratio
and postoperative/preoperative SIRI ratio were both above 0.800，and the postoperative/preoperative SIRI ratio had a higher sensitivity
of 95.3% and specificity of 70.2% than other indicators. Conclusions：The postoperative/preoperative NLR ratio and postoperative/
preoperative SIRI ratio have reference value for predicting PEP in choledocholithiasis patients undergoing ERCP.
［Key words］ acute pancreatitis；endoscopic retrograde cholangiopancreatography；neutrophil to lymphocyte ratio；systemic inflamma⁃
tion response index
［J Nanjing Med Univ，2026，46（05）：685⁃690］
［基金项目］ 江苏省中医药管理局科技发展计划重点项目（ZD202328）
通信作者（Corresponding author），E⁃mail：linmiao@njmu.edu.cn（ORCID：0000⁃0003⁃0248⁃2544）
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