文案 | 袁 浩
审核 | 孙晓冰
NLR？啥玩意儿？
中性粒细胞？淋巴细胞？比值？
这玩意儿有啥用？
NLR的全称是中性粒细胞与淋巴细胞比值，反映了免疫炎症反应的强度和对损伤或疾病的超生理应激，是细胞免疫激活的一个新的角度标志物，对来自自主神经系统、内分泌系统(催乳素、雄激素、雌激素、皮质醇、儿茶酚胺、甲状腺激素)和循环介质的各种刺激所做出的复杂反应, 是应激和系统性炎症的有效指标。NLR结合了中性粒细胞和淋巴细胞的变化，使其比单独一种更加敏感，在确定了临床背景的情况下，达到了1/1>1的效果！
针对高NLR状态，细胞因子监测是一个选择。
往期推荐
嘉会检验，公众号：嘉会检验细胞因子“挖一挖”
那么NLR具体在哪些方面能发挥作用？
诊断，疾病分类学 | Cut-off值，IQR，范围 | 第一作者，出版年份 |
感染，菌血症，细菌性肺炎，病毒感染， COVID-19 | NLR≥3-7 细菌感染 NLR≥10-11菌血症、脓毒症 NLR≥7-11 细菌肺炎 NLR≥3-7轻症COVID-19 NLR≥7-11重症COVID-19 | Wyllie 2005, Chalupa 2011, Holub 2012, de Jager 2010, 2012, Loonen 2014,Sen 2016, Russel 2019, Marik 2020, Lian 2020, Liu 2020, Ye 2020, Fu 2020,Ma 2020, Generali 2021, Imran 2021, Nestor 2021, Sciacchitano 2021 |
急性胰腺炎 | NLR≥4-7 轻微AP NLR≥7-11 中度AP NLR≥11-17 重度AP | Azab 2011, Suppiah 2013, Kokulu 2018, Cho 2018, Yu 2019, Kong 2020,Ekin 2020, Mubder 2020 |
急性阑尾炎 | NLR≥3.1-4卡他性 NLR≥3.5-5.0血清化脓性 NLR≥5.5-7.0坏疽性 | Ishizuka 2012, Kahramanca 2014, Toktas 2017, Goodman 1995, Celik 2019 |
脓毒症和脓毒性休克，SIRS，危重症 | NLR≥7-17,IQR3-23 脓毒症 NLR≥11-17脓毒症休克 NLR＜0.7-0.5-0.2中兴细粒细胞减少 NLR≥3-13非感染性SIRS | Salciccioli 2015, Riché 2015, Gurol 2015, Gucyetmez 2016, Liu 2016, Hwang2017, Arif 2017, Yoldas 2018, Ljungstrom 2017, Sari 2019, Farkas 2020, Marik 2020, Zhou 2021, Zhong 2021 |
急性冠脉综合征 急性心肌梗死 非STEMI, STEMI，预后 | NLR≥3.34-4.0（非STEMI） NLR≥3.8-5.5 （STEMI） NLR≥5.7-6.3（不良预后） | Tamhane 2008, Akpek 2012, Arbel 2012, Bhat 2013, Pan 2014, Kurtul 2015,Chen 2018, Park 2018 |
急性卒中，缺血性，出血性 | NLR≥4.1-5.0 NLR≥4.6-5.4 NLR≥5.7-8.5（不良预后） | Tokgoz 2013, Celikbilek 2014, Erturk 2014, Brooks 2015, Lattanzi 2016,2020, Giede-Jeppe 2017, Wang 2018, Ozgen et al 2020 |
头颈癌，简称SCCM | NLR≥2.6-3.0 NLR≥4.0-5.0 | Millrud R.C 2012, Young 2014, Panje 2017, Gorphe 2018, Sato 2017,Ferrandino 2016, 2020, Andersson 2019 |
泌尿外科，肾癌，前列腺癌 | NLR≥2.7-3.0 NLR≥3.3-3.6 | Ohno 2010,2012, Pichler 2013, Kuzman 2017, Hu 2015, Tan 2017, Luo2015, 2018 |
食管癌和胃癌 | NLR≥2.6-4.0 NLR≥4.0-5.0 NLR≥5.0 | Rashid 2010, Yamanaka 2007, Jung 2011, Aliustaoglu 2010, Shimada 2010,Miyata 2011, Sato 2012, Jeong 2012, Lee 2013, Kim 2015, Ishizuka 2014,Sun X 2016, Strumfa 2017, Yao 2018 |
胰腺癌，胰腺导管腺癌 | NLR≥4.0 NLR≥5.0 NLR≥3.6-5.1 | Smith R 2009, Bhatti 2010, An 2010, Garcea 2011, Luo 2015, Yang 2015,Cheng 2015, Lee 2018, Zhou 2018, Howard 2019, Iwai 2020 |
肝癌，肝转移 | NLR≥4.0 NLR≥5.0 | Gomez 2008, Hakazun 2008, Neal 2011, Kinoshita 2012, Motomura 2013,Aino 2013, Qi 2016, Wang 2020 |
结肠直肠癌 | NLR≥2.5-3.0,IQR 2.3-5.5 NLR≥3.1-4.0 NLR≥4.0-5.0 | Walsh 2005, Cook 2007, Chua 2011, Kantola 2012, Jankova 2013,Templeton 2014, Ozgehan 2014, Malietzis 2014, Seong 2015, Mei 2017,Benlice 2019, Yoshida 2020 |
妇科，卵巢癌，子宫颈和外阴癌 | NLR≥2.6-3.3.NLR 2.5-3.9 NLR≥2.3-5.26 NLR≥2.6-4.0 | Cho 2009, Li 2015, Wu 2017, Prodromidou 2017 ethier 2017, Zhoua 2017,Zhao 2018, Ding 2019, Lee 2021 |
肉瘤，软组织肉瘤 | NLR≥5.0 NLR≥4.0 | Idowu 2012, Szkandera 2015, Liu G 2018 |
乳腺癌 | NLR≥3.0-3.3 NLR≥2.57-4.0 | Azab 2013, Dirican 2015, Liu 2016 Ethier J-L 2017, Yao 2014 |
皮肤癌，恶性黑色素瘤 | NLR≥4.0 NLR≥5.0 | Ferruci 2015, Zaragoza 2016, Ding 2018, Cohen et al 2020, Fattore 2021 |
肺癌、肺非小细胞癌和肺腺癌 | NLR≥2.63-3.25 NLR≥4.74-5.0 | Sarraf 2009, Sakai 2011, Tomita 2011, Kao 2010, Yao 2012, Ishihara 2021 |
骨科，重度创伤；烧伤病人 | NLR≥3.3-4.0 NLR≥4.0-5.0 NLR≥3.6-4.0 NLR≥3.5-5.5 | Hefernnan 2012, Forget 2015, Emektar 2017, Fisher 2016, Angulo 2020,Temiz 2019, Bac 2020, Wang 2020, Qiu 2021 |
溃疡性结肠炎，炎症性肠病 | NLR≥3.3 NLR≥4.1-5.0 | Celikbilek 2013, Acarturk 2015, Gao 2015, Kang 2017, Argeny 2018 |
精神病学双相障碍，抑郁症，精神分裂症 | NLR≥2.3-4.0 NLR≥2.4-3.0 NLR≥2.5-4.0 | Aydin 2016, Demir 2015, Demircan 2016, Kalelioglu 2015, 2019,Karamustafalioglu 2019, Kulaksizoglu 2019, Ozdin 2020, Mazza 2018 |
紧急医疗（Urgent medicine） 紧急情况（emergency） | NLR≥10 NLR≥12 | Wyllie 2004, de Jager 2010, 2012, Loonen 2014, Vallejo 2017, Kim Park 2019, Westerdijk 2019 |
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下期预告：MLR PLR为何物？
备注：本文部分图片来源于网络
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