C-反应蛋白/白蛋白比值联合中性粒细胞/淋巴细胞比值对膀胱癌根治术老年病人并发术后认知功能障碍的预测价值

doi:10.3969/j.issn.1003-9198.2023.11.011

摘要/Abstract

摘要： 目的探讨C-反应蛋白/白蛋白比值(CAR)联合中性粒细胞/淋巴细胞比值(NLR)对膀胱癌根治术老年病人并发术后认知功能障碍(POCD)的预测价值。方法选择2019 年1月至2022年10月在本院接受膀胱癌根治术的老年病人660例作为研究对象,并根据是否并发POCD将病人分为POCD组(182例)和非POCD组(478例)。收集病人基本临床资料,比较2组CAR和NLR水平;采用Logistic回归分析膀胱癌根治术老年病人并发POCD的影响因素。绘制ROC曲线,分析CAR、NLR及两指标联合对膀胱癌根治术老年病人并发POCD的预测价值。结果 POCD组年龄、受教育程度、吸烟、脑血管疾病、术前MMSE评分＜26分、手术时间≥3 h的比例及CAR和NLR水平等与非POCD组比较,差异均有统计学意义(P＜0.05或P＜0.01)。多因素Logistic 回归分析显示,经校正其他影响因素后,CAR、NLR值升高是膀胱癌根治术老年病人并发POCD的独立危险因素。ROC曲线分析显示,CAR与NLR联合检测预测膀胱癌根治术老年病人并发POCD的AUC为0.894,明显大于CAR的0.787和NLR的0.811,差异均具有统计学意义(P＜0.01)。结论 CAR联合NLR对膀胱癌根治术老年病人并发POCD有较高的预测价值。

关键词: 老年人, 膀胱癌根治术, 术后认知功能障碍, C-反应蛋白/白蛋白比值, 中性粒细胞/淋巴细胞比值, 预测价值

Abstract: Objective To investigate the predictive value of C-reactive protein to albumin ratio(CAR) combined with neutrophil to lymphocyte ratio(NLR) for postoperative cognitive dysfunction(POCD) in the elderly patients undergoing radical cystectomy for bladder cancer. Methods A total of 660 elderly patients who underwent radical cystectomy for bladder cancer in our hospital from January 2019 to October 2022 were enrolled in this study, and the patients were divided into the POCD group(n=182) and the non-POCD group(n=478) according to whether they presented with POCD. The basic clinical data of the patients were collected, and the levels of CAR and NLR were compared between the two groups. The influencing factors of POCD in the elderly patients undergoing radical cystectomy for bladder cancer were analyzed by Logistic regression model. Receiver operating characteristic(ROC) curve was used to analyze the predictive value of CAR, NLR and their combination for POCD in the elderly patients undergoing radical cystectomy for bladder cancer. Results There were significant difference in age, smoking, cerebrovascular disease, proportion of preoperative Mini Mental State Examination(MMSE) score <26 and operation time≥3 hours, and the levels of CAR and NLR between the POCD group and the non-POCD group(P＜0.05 or P＜0.01). Multivariate Logistic regression analysis showed that elevated CAR and NLR were independent risk factors for POCD in the elderly patients undergoing radical cystectomy for bladder cancer after adjusting other influencing factors. According to ROC curve analysis,the area under curve (AUC) of the combined detection of CAR and NLR in predicting POCD in the elderly patients undergoing radical cystectomy for bladder cancer was 0.894, which was significantly higher than that of CAR alone(AUC=0.787) or NLR alone(AUC=0.811), respectively, with statistically significant differences(P<0.01). Conclusions CAR combined with NLR has a high predictive value for POCD in the elderly patients undergoing radical cystectomy for bladder cancer.

Key words: aged, radical cystectomy for bladder cancer, postoperative cognitive dysfunction, C-reactive protein to albumin ratio, neutrophil to lymphocyte ratio, predictive value

中图分类号:

R 737.14

梁安施, 谢彩叶. C-反应蛋白/白蛋白比值联合中性粒细胞/淋巴细胞比值对膀胱癌根治术老年病人并发术后认知功能障碍的预测价值[J]. 实用老年医学, 2023, 37(11): 1125-1129.

LIANG An-shi, XIE Cai-ye. Predictive value of C-reactive protein to albumin ratio combined with neutrophil to lymphocyte ratio for postoperative cognitive dysfunction in elderly patients undergoing radical cystectomy for bladder cancer[J]. Practical Geriatrics, 2023, 37(11): 1125-1129.

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