中性粒细胞与淋巴细胞比值预测一氧化碳中毒所致迟发性神经后遗症：系统综述与荟萃分析。
完整摘要 · 中文译文
背景：本研究总结并分析了中性粒细胞与淋巴细胞比值（NLR）对一氧化碳（CO）中毒所致迟发性神经后遗症（DNS）的预后价值。 方法：检索 PubMed、Embase、Cochrane Library、Web of Science、ScienceDirect 和中国知网数据库，检索时间从各数据库建库至 2026 年 2 月，以筛选相关文献。通过比值比及其 95% 置信区间（CI）、曲线下面积、meta 回归分析、敏感性分析和发表偏倚评估 NLR 对 DNS 的预测价值。 结果：共纳入 8 项研究，涉及 1757 例急性 CO 中毒患者，其中 382 例（21.7%）发生 DNS。汇总结果显示，NLR 与 DNS 相关（比值比 = 14.67，95% CI：8.26-26.04，P < .001），且具有较高的异质性（I² = 65.1%，P = .005）。NLR 预测 DNS 的曲线下面积为 0.88（95% CI：0.85-0.91），敏感性为 86%，特异性为 72%。亚组分析提示研究设计可能是异质性的来源。敏感性分析提示结果稳健。Deek 检验未发现显著发表偏倚（P = .24）。 结论：当前证据表明，NLR 升高与急性 CO 中毒后 DNS 风险增加相关，支持其作为预后标志物的潜在价值。然而，由于纳入研究存在显著异质性且以回顾性研究为主，这些结果应谨慎解读，并需要在高质量研究中加以验证。 前瞻性研究。因此，NLR 应被视为风险分层的辅助工具，而非独立的诊断方法。其主要临床价值可能在于无法进行高级监测的资源有限环境中。
完整摘要 · 英文原文
BACKGROUND: This study summarized and analyzed the prognostic value of the neutrophil to lymphocyte ratio (NLR) for delayed neurologic sequelae (DNS) caused by carbon monoxide (CO) poisoning. METHODS: PubMed, Embase, Cochrane Library, Web of Science, ScienceDirect, and China National Knowledge Infrastructure Database were searched to identify relevant articles from their inception to February 2026. The odds ratio and its 95% confidence interval (CI), area under the curve, meta-regression analysis, sensitivity analysis, and publication bias for NLR were estimated to predict DNS. RESULTS: Eight studies were included, involving 1757 patients with acute CO poisoning, among whom 382 cases (21.7%) developed DNS. The pooled results show that NLR was related to DNS (odds ratio = 14.67, 95% CI: 8.26-26.04, P < .001) and had high heterogeneity (I2 = 65.1%, P = .005). The area under the curve of NLR for predicting DNS was 0.88 (95% CI: 0.85-0.91), with a sensitivity of 86% and a specificity of 72%. Subgroup analysis indicated that study design may be the source of heterogeneity. Sensitivity analysis suggested the robustness of the results. Deek's test did not detect significant publication bias (P = .24). CONCLUSION: Current evidence indicates that an elevated NLR is associated with an increased risk of DNS after acute CO poisoning, supporting its potential utility as a prognostic marker. However, because the included studies showed substantial heterogeneity and were predominantly retrospective, these findings should be interpreted with caution and require validation in high-quality prospective studies. NLR should therefore be considered an auxiliary tool for risk stratification rather than an independent diagnostic method. Its principal clinical value may lie in resource-limited settings where advanced monitoring is not feasible.