探讨术前中性粒细胞与淋巴细胞比值(NLR)对急性胆管炎伴胆总管结石患者手术预后评估的临床意义。

选取江苏大学附属武进人民医院普外科2016年1月至2019年6月收治的急性胆管炎伴胆总管结石行手术治疗的患者60例为研究对象进行回顾性研究，其中男性27例，女性33例；年龄46～88岁，平均(67.93±11.46)岁。术前NLR <5.435患者作为低NLR组(31例)，NLR≥5.435患者作为高NLR组(29例)。比较两组患者术前白细胞计数、C反应蛋白、谷草转氨酶、谷氨酰转肽酶水平；同时分析两组住院总天数、术后住院天数、住院总费用等。

低NLR组白细胞计数低于高NLR组[(6.28±1.66)×10⁹/L比(10.59±3.55)×10⁹/L，P<0.05 ]；低NLR组C反应蛋白水平低于高NLR组[(57.63±47.68)ug/mL比(81.38±38.25)ug/mL，P<0.05 ]；低NLR组谷草转氨酶水平低于高NRL组[(96.17±71.25)U/L比(281.90±438.30)U/L，P<0.05]；低NLR组谷氨酰转肽酶水平均低于高NLR组[(297.57±255.97)U/L比(509.70±462.06)U/L，P<0.05]，差异有统计学意义(P<0. 05)。低NLR组住院总天数[(13.34±4.55)d比(15.49±3.94)d，P<0.05]、术后住院天数[(10.07±2.80)d比(11.6±3.41)d，P<0.05]及住院总费用[(26 984.78±4 316.30)元比(30 875.35＝±4 305.50)元，P<0.05]等均低于高NLR组，差异有统计学意义(P<0. 05)。

急性胆管炎伴胆管结石患者外周血NLR值与其炎症感染程度呈正相关，临床上可将NLR作为对其病情及手术预后进行评估的指标。

To investigate the clinical significance of preoperative neutrophil/lymphocyte ratio (NLR) in evaluating the prognosis of patients with acute cholangitis complicated with choledocholithiasis.

From January 2016 to June 2019, 60 patients with acute cholelithitis complicated with choledocholithiasis were treated in the Department of General Surgery of Wujin people's Hospital affiliated to Jiangsu University, were selected as subjects for retrospective study, including 27 males and 33 females, aged 46-88 years with an average age of (67.93±11.46) years. Preoperative NLR<5.435 patients were treated as low NLR group (31 patients), NLR tientsed as subjects for r(29 patients), white blood cell count, C-reactive protein, glutamic oxaloacetic transaminase and glutamyl transaminase levels were compared between the two groups, and the levels of leukocyte count, C-reactive protein, glutamic oxaloacetic transaminase and glutamyl transaminase in the two groups were analyzed by total hospitalization days, postoperative hospitalization days, total hospitalization expenses, etc.

The levels of leukocyte count [(6.28±1.66)×10⁹/L vs (10.59±3.55)×10⁹/L, P<0.05 ], C-reactive protein [(57.63±47.68)ug/mL vs (81.38±38.25)ug/mL, P<0.05 ], glutamic oxaloacetic transaminase [(96.17±71.25)U/L vs (281.90±438.30)U/L , P<0.05] and glutamyl transaminase [(297.57±255.97)U/L vs (509.70±462.06)U/L, P<0.05] in low NLR group were significantly lower than those in the high NLR group (P<0.05). The total hospitalization days [(13.34±4.55)days vs (15.49±3.94)days, P<0.05], postoperative hospitalization days [(10.07±2.80)days vs (11.6±3.41)days, P<0.05] and total hospitalization expenses [(26 984.78±4 316.30)CNY vs (30 875.35=±4 305.50) CNY, P<0.05] in the low NLR group were significantly lower than those in the high NLR group (P<0. 05).

The NLR value of peripheral blood in patients with acute cholangitis with cholelithiasis is positively correlated with the degree of inflammatory infection, suggesting that NLR is consistent with the actual severity of the patient and has a prognosis for surgical treatment.