肺血栓栓塞症患者炎症指标的变化特征

目的 探讨肺血栓栓塞症(pulmonary thromboembolism,PTE)患者炎症指标的变化特点及其在临床诊断中的价值。 方法 收集从2012年1月—2017年6月于蚌埠医学院第一附属医院确诊为PTE的83例患者血液白细胞计数(WBC)、中性粒细胞计数(NE)、淋巴细胞计数(LY)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、C反应蛋白(CRP)、体温(T)、纤维蛋白原(FIB)等炎症指标，与同期64例健康体检者指标进行比较，回顾性分析2组研究对象炎症指标的变化，并根据年龄、是否合并肺部感染分别对PTE患者进行亚组分析，并分析NLR、PLR与传统炎症指标及凝血纤溶指标间相关性。 结果 与对照组比较，PTE组WBC、NE、NLR、PLR显著增高，LY显著降低，差异均有统计学意义(P<0.05)；PTE合并肺部感染组与不合并感染组间，老龄PTE组与非老龄PTE组间T、WBC、NE、CRP、NLR、PLR比较差异无统计学意义(均P>0.05)；PTE组NLR与WBC、NE、CRP成正相关关系(r=0.531、r=0.674、r=0.408，均P<0.01)；PLR与CRP成正相关关系，(r=0.472，P<0.01)；PTE组NLR和PLR均与FIB成正相关关系(r分别为0.231和0.405，均P<0.05)。 结论 PTE组WBC、NE、NLR、PLR明显升高，炎症与PTE的发生发展存在联系；NLR、PLR不能用于鉴别PTE患者是否同时合并肺部感染；NLR、PLR与CRP、FIB间有一定相关性，可用于监测PTE患者的炎症及凝血纤溶变化。 

Characteristics of inflammatory markers in patients with pulmonary thromboembolism

Objective To investigate the characteristics of inflammatory markers in patients with pulmonary thromboembolism (PTE) and its value in clinical diagnosis. Methods Blood samples from 83 patients diagnosed with PTE from the First Affiliated Hospital of Bengbu Medical College from January 2012 to June 2017 were collected for white blood cell (WBC), Neutrophil count (NE), and Lymphocyte count (LY), Neutrophil percentage (NE%), Neutrophil to Lymphocyte Ratio (NLR), Platet to Lymphocyte Ratio (PLR) , C-Reactive protein (CRP), Temperature (T), Fibrinogen (FIB) and other indicators of inflammation compared with 64 healthy physical indicators in the same period, and the changes of inflammation indexes in the two groups were retrospectively analyzed. Patients with pulmonary thromboembolism were divided according to age and whether they had pulmonary infection at the same time, and the correlation between NLR, PLR and traditional inflammation indicators and coagulation and fibrinolysis indicators were analyzed. Results Compared with the control group, the WBC, NE, NLR and PLR in the PTE group were significantly increased, and the LY was significantly decreased (P<0.05). There was no significant difference in T, WBC, NE, CRP, NLR and PLR between PTE combined with pulmonary infection group and PTE non-infection group (all P>0.05). There was no significant difference in T, WBC, NE, CRP, NLR and PLR between PTE combined with Older PTE group and non-aged PTE group(P> 0.05); NLR values of PTE patients were positively correlated with WBC, NE and CRP levels (r values were 0.531, 0.674 and 0.408, respectively, P values were <0.01); PLR values were positively correlated with CRP levels (r=0.472, P<0.01). Both NLR and PLR in the PTE group were positively correlated with FIB (r=0.231 and 0.405, respectively, all P<0.05). Conclusion WBC, NE, NLR and PLR are significantly elevated in PTE group. It was suggested that there may be a link between inflammatory response and the development of PTE. It was suggested that the inflammatory index like NLR and PLR could not accurately identify whether the patient was a simple PTE patient or a pulmonary infection at the same time. There is a correlation between the NLR, PLR and the CRP, FIB, which can be used to monitor inflammation and coagulation and fibrinolysis in patients with PTE.