红细胞分布宽度及中性粒细胞/淋巴细胞比值在IE患者中的临床意义

目的探究红细胞分布宽度(RDW)和中性粒细胞/淋巴细胞比值(NLR)在感染性心内膜炎(IE)患者中的水平与临床意义。方法选取2014年12月至2018年3月该院感染科收治,诊断为“IE”的患者为IE组,同期体检的健康人群为健康对照组,同期住院的冠状动脉粥样硬化性心脏病(CHD)患者为CHD组,收集统计患者的影像学检查资料、病历资料、化验检查资料进行统计学分析。结果NLR在IE组与健康对照组之间比较差异有统计学意义(P<0.05);红细胞分布宽度变异系数(RDW-CV)在IE组与健康对照组、IE血培养阳性组与IE血培养阴性组之间比较差异有统计学意义(P<0.05);红细胞分布宽度标准差(RDW-SD)在IE组与健康对照组、IE血培养阳性组与健康对照组之间比较差异有统计学意义(P<0.05)。受试者工作特征曲线(ROC曲线)下面积(AUC)0.926,灵敏度89.2%,特异度86.3%,提示联合应用NLR和RDW-CV可以使诊断效能提高。结论NLR、RDW在感染相关疾病的预后方面有较广阔的应用前景,但在IE患者的诊断作用有限,在预后方面的作用,需要更大样本量、多中心的临床队列研究证实。

Clinical significance of red blood cell distribution width and neutrophil/lymphocyte ratio in patients with IE

Objective To investigate the level and clinical significance of red blood cell distribution width(RDW)and neutrophil/lymphocyte ratio(NLR)in patients with infective endocarditis(IE).Methods From December 2014 to March 2018,the patients diagnosed as IE were selected from the hospital and selected as IE group.The healthy people who had physical examination at the same time were selected as healthy control group,and the patients who were hospitalized at the same time coronary atherosclerotic heart disease(CHD)were selected as CHD group.The imaging examination data,medical record data and laboratory examination data of the patients were collected for statistical analysis.Results NLR was significantly different between IE group and healthy control group(P<0.05);RDW-CV was significantly different between IE group and healthy control group,IE blood culture positive group and IE blood culture negative group(P<0.05);RDW-SD was significantly different between IE group and healthy control group,IE blood culture positive group and healthy control group(P<0.05).Area under the receiver operating characteristic curve(ROC curve)was 0.926,sensitivity was 89.2%,specificity was 86.3%,indicating that the combination of NLR and RDW-CV could improve the diagnosis efficiency.Conclusion NLR and RDW have broad application prospects in the prognosis of infection-related diseases,but their diagnostic role in IE patients is limited,and their role in prognosis requires a larger sample size and multicenter clinical cohort studies to confirm.