Predictive Value Of NLR In Patients With Acute Pancreatitiscomplicated With Organ Dysfunction

Objective: 1.To explore the predictive value of neutrophil-lymphocyte ratio(NLR)in acute pancreatitis(AP)complicated with ARDS.2.To explore the predictive value of neutrophil-lymphocyte ratio(NLR)in acute pancreatitis(AP)complicated with AKI.Methods: The clinical data of patients with acute pancreatitis(AP)who were admitted to Shanxi Provincial People's Hospital from October 2015 to February 2018 were analyzed retrospectively.According to ARDS Berlin criteria in 2012,the patients was divided into ARDS positive group and ARDS negative group according to the occurrence of ARDS.According to AKI KDIGO criteria in 2012,the patients was divided into AKI positive group and AKI negative group according to the occurrence of AKI.The clinical indicators,biochemical indicators and NLR of the two groups were observed.The t-test and chi-square test were used to compare the NLR and other indicators between the two groups.The receiver operating characteristic(ROC)curve and logistic regression analysis were used to evaluate the predictive value of NLR and other indicators for AP related with ARDS and AKI.Results: In the ARDS group: of the 93 patients who met the criteria,18 were in the ARDS-positive group and 75 in the ARDS-negative group.There were significantdifferences in WBC,neutrophil count(NEUT),lymphocyte count(LY),NLR,lymphocyte-to-monocyte ratio(LMR),and heart rate between the two groups(P<0.05).The optimal cutoff values under the ROC curve are: NLR15.43,WBC17.05×109/L,and the area under the ROC curve is NLR0.948,WBC0.869,and the combined detection is 0.955.When NLR and WBC were connected in series,the specificity of ARDS in predicting AP was 100%,The sensitivity of ARDS and WBC in parallel detection was 88.9%(11.1% misdiagnosis rate).In the AKI group: of the 71 patients who met the criteria,14 were in the AKI-positive group and 57 in the AKI-negative group.There were significant differences in blood calcium,neutrophil count(NEUT),lymphocyte count(LY),NLR,lymphocyte-to-monocyte ratio(LMR),and heart rate between the two groups(P<0.05).The optimal cutoff values under the ROC curve are: NLR12.51,blood calcium 1.95mmol/L,and the area under the ROC curve is NLR0.925,blood calcium 0.896,and the combined detection is 0.964.When NLR and blood calcium were connected in series,the specificity of AKI in predicting AP was 100%,The sensitivity of AKI and blood calcium in parallel detection was 100%.Conclusion: NLR and WBC are closely related to AP complicated with ARDS,and the combined detection of the two has the highest specificity and sensitivity for early prediction of AP complicated with ARDS,and has important clinical value.NLR and blood calcium are closely related to AP complicated with AKI,and the combined detection of the two has the highest specificity and sensitivity for early prediction of AP complicated with AKI,and has important clinical value.