The Value Of The Ratio Of Neutrophils To Lymphocytes And Platelets(N/LP) In The Prognosis Of Patients With Septic Acute Kidney Injury

Objective:To explore the significance of the ratio of neutrophils to lymphocytes and platelets(N/LP)in the evaluation of the severity of Sepsis induced Acute Kidney Injury(SIAKI).It is hoped that it can provide the clinical basis for the diagnosis and treatment,condition evaluation and prognosis judgment of acute kidney injury caused by sepsis.Methods:Selection in January 2017 to May 2020,a critical period of anhui anqing hospital affiliated to medical university medicine diagnosis and treatment of 137 cases of hospitalized sepsis in patients with acute kidney injury as the research object,collect general data and clinical data of patients,a retrospective study,after admission according to sepsis and acute kidney injury treatment guidelines for regular treatment,Based on the prognosis at 28 days,the patients were divided into survival group(n =51)and death group(n =86).The lymphocyte count,platelet count and neutrophil count of routine examination items within 24 hours after admission were collected and sorted out,and the N/LP ratio,Apache II score and Roche AKI score were calculated.The differences between the two groups were compared.To evaluate the prognostic value of N/LP in septic AKI patients,and to analyze the correlation between N/LP and Apache II score and Roche AKI score.Results:1.There was no statistically significant difference in gender between the two groups(P > 0.05 for both groups).The age,N/LP*100 and Apache II scores of the patients in the death group were significantly higher than those in the survival group within 24 hours after admission,with statistically significant differences(P < 0.05 for the two groups).Spearman correlation analysis showed that there was a significant positive correlation between N/LP*100 and Apache II scores within 24 hours after hospitalization(r=0.276 P=0.001),and there was a significant positive correlation between N/LP*100 and Roche AKI scores(r=0.342 P=0.000).The area under the AUC curve of N/LP*100 was 0.619(95%CI 0.522-0.716),the sensitivity was 65.10%,the specificity was 58.80%,and the cut-off value was 16.1056%.The area under the AUC curve of the Apache II score was 0.677(95% confidence interval 0.584-0.711),the sensitivity was 48.80%,the specificity was 82.40%,and the cutoff value was 19.500.The area under the AUC curve of Roche AKI score was 0.647(95% confidence interval0.551-0.744),the sensitivity was 69.8%,the specificity was 60.80%,and the cutoff value was 9.50.The area under the AUC curve of N/LP*100+ Roche AKI score was 0.655(95% confidence interval 0.559--0.751),the sensitivity was 77.90%,and the specificity was 52.90%.Conclusion:(1)N/LP within 24 h of admission has a good predictive value for acute kidney injury secondary to sepsis,and is correlated with the severity of patients with septic AKI and the prognosis of sepsis;(2)Apache II score has a good predictive value for acute kidney injury secondary to sepsis;(3)N/LP*100 combined with Roche AKI score has a high sensitivity and specificity for the prediction of acute kidney injury secondary to sepsis.