【摘要】 目的 探讨术前外周血中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、血小板与淋巴细胞比值(PLR)、系统性免疫性炎症指数(SII)、凝血功能指标及血清人绒毛膜促性腺激素(β-HCG)、孕酮(P)对输卵管妊娠(TP)破裂诊断的预测价值。方法 选取经过腹腔镜手术诊断为TP破裂的146例患者作为观察组，经腹腔镜诊断为TP未破裂的112例患者作为对照组，记录2组患者的一般资料及术前血常规、凝血功能指标[血浆凝血酶原时间(PT)、国际标准化比率(PT-INR)、凝血酶原活动度(PTA)、活化部分凝血活酶时间(APTT)]及β-HCG、P，根据血常规结果计算NLR、MLR、PLR及SII，比较上述各指标在观察组和对照组中的差异，将有差异的指标纳入多因素logistic回归，分析TP破裂的独立危险因素;采用受试者工作(ROC)曲线下面积(AUC)评估NLR、MLR、PLR、SII、β-HCG、P对TP破裂诊断的预测效能。结果 与对照组比较，观察组的NLR、MLR、PLR、SII、β-HCG及P升高(P <0.05)，其余指标比较，差异无统计学意义(P> 0.05); logistic分析结果显示，NLR、PLR、SII、β-HCG及P是TP破裂的独立危险因素; ROC结果显示NLR、PLR、SII、β-HCG、P单一或五者联合预测TP破裂的AUC分别为0.749、0.694、0.712、0.802、0.752及0.934，五者联合的AUC最大。结论 NLR、PLR、SII、β-HCG及P对TP破裂诊断均有一定的预测价值，五者联合检测的价值最大。更多还原

【Abstract】 Objective To investigate the predictive value of preoperative peripheral blood neutrophilto-lymphocyte ratio( NLR), monocyte-to-lymphocyte ratio( MLR), platelet-to-lymphocyte ratio( PLR),systemic immune inflammatory index( SII),coagulation function index,and serum β-human chorionic gonadotropin( β-HCG) and progesterone( P) in the diagnosis of ruptured tubal pregnancy( TP). Methods A total of 146 patients with ruptured TP after laparoscopic surgery were selected as the observation group,and 112 patients with unruptured TP after laparoscopy as the control group. The general information and preoperative blood routine,coagulation function indexes [plasma prothrombin time( PT),international normalized ratio( PT-INR),plasminogen activity( PTA),activated partial thromboplastin time( APTT) ]and β-HCG,P,in the 2 groups were recorded. NLR,MLR,PLR,SII were calculated according to the results of blood routine,and the differences of the above indexes were compared between both groups. Multifactorial logistic regression analysis was used to analyze the independent risk factors for TP rupture,and the predictive diagnostic efficacy of NLR,MLR,PLR,SII,β-HCG,and P-values was evaluated using the area under the curve( AUC) of the receiver operating characteristic curve( ROC). Results Compared with the control group,NLR,MLR,PLR,SII,β-HCG and P were elevated in the observation group( P < 0. 05),while the rest of the indexes were compared,and the difference was not statistically significant( P > 0. 05). The results of logistic analysis showed that NLR,PLR,SII,β-HCG and P were independent risk factors for TP rupture. The ROC results showed that the AUCs of NLR,PLR,SII,β-HCG,P single,or a combination of all five for predicting TP rupture were 0. 749,0. 694,0. 712,0. 802,0. 752,and 0. 934,respectively,and the AUC of the combination of all five was the largest. Conclusion NLR,PLR,SII,β-HCG,and P have some diagnostic value in the diagnosis of ruptured TP,and the combined indexes are superior to a single test.更多还原