High blood neutrophil-lymphocyte ratio associated with poor outcomes in miliary tuberculosis
High blood neutrophil-lymphocyte ratio associated with poor outcomes in miliary tuberculosis
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DOI：
10.21037/jtd.2017.12.65
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发表时间：
2018-01-01
影响因子：
2.5
通讯作者：
Lee, Jin Hwa
中科院分区：
文献类型：
--
作者：
Han, Yeji;Kim, Soo Jung;Lee, Jin Hwa
背景：军队结核（TB）的预后难以预测。我们假设血液中性粒细胞-淋巴细胞比率（NLR）是反映军队结核患者炎症状态的独立预后意义的指标。本研究旨在探讨军人结核患者NLR与转归的关系。方法：回顾性收集1995年1月至2016年1月在某三级转诊医院诊断为军人结核病的患者资料。结果：共纳入96例患者。17例（18%）患者在住院期间死于军旅性结核病，9例（9%）患者在1年随访期间额外死亡。18例（19%）被诊断为急性呼吸窘迫综合征（ARDS）。在多元logistic回归分析中，NLR升高与ARDS相关[校正优势比为1.15；95%置信区间（CI）， 1.03-1.28]。通过多因素Cox回归分析，校正已知预后因素包括年龄、性别、体重指数、血清天冬氨酸转氨酶（AST）和血红蛋白，NLR是院内死亡率的独立预测因子[校正危险比（aHR）， 1.08；（95% CI, 1.03-1.13）和1年死亡率（aHR, 1.08; 95% CI, 1.05-1.12）。结论：入院前治疗NLR可能是军人结核患者死亡率和ARDS发展的有用生物标志物。
Background: It is difficult to predict the prognosis of miliary tuberculosis (TB). We hypothesized that blood neutrophil-lymphocyte ratio (NLR) is an indicator of inflammatory status to reflect independent prognostic significance in patients with miliary TB. The aim of this study is to investigate the relationship between NLR and outcome in miliary TB.Methods: We retrospectively collected data from patients diagnosed with miliary TB in a tertiary referral hospital between January 1995 and January 2016.Results: A total of 96 patients were enrolled. Seventeen patients (18%) died during hospitalization due to miliary TB, and 9 (9%) died additionally during the 1-year follow-up period. Eighteen patients (19%) were diagnosed with acute respiratory distress syndrome (ARDS). In multiple logistic regression analyses, increased NLR was associated with ARDS [adjusted odds ratio, 1.15; 95% confidence interval (CI), 1.03-1.28]. By multivariate Cox regression analysis with adjustment of known prognostic factors including age, sex, body mass index, serum aspartate aminotransferase (AST), and hemoglobin, NLR was an independent predictor of in-hospital mortality [adjusted hazard ratio (aHR), 1.08; 95% CI, 1.03-1.13] and 1-year mortality (aHR, 1.08; 95% CI, 1.05-1.12).Conclusions: Pre-treatment NLR at admission may be a useful biomarker for mortality and development of ARDS in patients with miliary TB.