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目的:分析中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、血小板计数(BPC)对成年大面积烧伤患者预后的判断价值。方法:2012年1月—2018年12月，福建医科大学附属协和医院收治符合入选标准的99例成年大面积烧伤患者[男76例、女23例，年龄18～75(43±13)岁]。根据预后，将患者分为存活组79例和死亡组20例，以病例对照研究的方法回顾性分析其临床资料。统计2组患者的性别、年龄、烧伤总面积、合并吸入性损伤和行机械通气情况，及伤后第1、3、7天白细胞计数、中性粒细胞计数、淋巴细胞计数、BPC，并计算NLR、PLR、伤后第3天与伤后第1天BPC的差值ΔBPC3、伤后第3天与伤后第1天NLR的差值ΔNLR3、伤后第3天与伤后第1天PLR的差值ΔPLR3、伤后第7天与伤后第1天BPC的差值ΔBPC7、伤后第7天与伤后第1天NLR的差值ΔNLR7、伤后第7天与伤后第1天PLR的差值ΔPLR7。对数据行Mann-Whitney n U检验、独立样本n t检验、n χ2检验，筛选患者死亡的相关因素，通过二分类单因素和多因素logistic回归分析，分析患者死亡的相关因素。绘制患者死亡的独立危险因素对成年大面积烧伤患者预后预测的受试者工作特征(ROC)曲线，计算曲线下面积及最佳阈值与最佳阈值下的敏感度、特异度。n 结果:(1)2组患者烧伤总面积、行机械通气情况比较，差异有统计学意义(n Z＝-2.615、n χ2＝7.282，n P<0.01)。(2)伤后第1天，2组患者NLR比较，差异有统计学意义(n Z＝-2.414，n P<0.05)。伤后第3天，2组患者BPC、ΔNLR3比较，差异均有统计学意义(n Z＝-2.048、-2.780，n P<0.05或n P<0.01)。伤后第7天，2组患者淋巴细胞计数、BPC、NLR、ΔNLR7比较，差异均有统计学意义(n Z＝-2.248、-2.231、-2.641、-3.669，n P<0.05或n P<0.01)。(3)二分类单因素logistic回归分析显示，烧伤总面积、机械通气、伤后第7天BPC和NLR、ΔNLR7与患者死亡相关(比值比＝1.038、0.193、0.990、1.086、1.105，95%置信区间＝1.010～1.067、0.062～0.598、0.982～0.998、1.012～1.165、1.037～1.178，n P<0.05或n P<0.01)；二分类多因素logistic回归分析显示，ΔNLR7是成年大面积烧伤患者死亡的独立危险因素(比值比＝1.090，95%置信区间＝1.008～1.178，n P<0.05)。(4)ΔNLR7对97例成年大面积烧伤患者预后死亡预测的ROC曲线最佳阈值为-0.073 4，最佳阈值下的敏感度为65.0%、特异度为78.5%，ROC曲线下面积为0.776(95%置信区间＝0.650～0.882，n P<0.01)。n 结论:动态监测NLR、BPC对协助判断成年大面积烧伤患者的预后有重要意义，ΔNLR7是成年大面积烧伤患者死亡事件的独立预测指标，而PLR不能很好地预测成年大面积烧伤患者的预后。“,”Objective:To investigate the value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and blood platelet count (BPC) in judging the prognosis of adult patients with extensive burns.Methods:From January 2012 to December 2018, 99 adult patients with extensive burns who met the inclusion criteria were admitted to Union Hospital of Fujian Medical University, including 76 males and 23 females, aged 18 to 75 (43±13) years. According to the prognosis, the patients were divided into survival group of 79 cases and death group of 20 cases. Their clinical data were retrospectively analyzed by the method of case-control study. The gender, age, total burn area, inhalation injury, use of mechanical ventilation and white blood cell count, neutrophil count, lymphocyte count, and BPC on post injury day (PID) 1, 3, and 7 were collected, and the NLR, PLR, difference value of BPC on PID 3 and PID 1 (ΔBPC3), difference value of NLR on PID 3 and PID 1 (ΔNLR3), difference value of PLR on PID 3 and PID 1 (ΔPLR3), difference value of BPC on PID 7 and PID 1 (ΔBPC7), difference value of NLR on PID 7 and PID 1 (ΔNLR7), difference value of PLR on PID 7 and PID 1 (ΔPLR7) of patients in the two groups were calculated. Data were statistically analyzed with Mann-Whitneyn U test, independent sample n t test, chi-square test to screen the death-related factors of patients. Binary classification single factor and multifactor logistic regression analysis were used to analyze the death-related factors of patients. The receiver′s operating characteristic (ROC) curve of the independent risk factor of death of patients predicting the prognosis of adult patients with extensive burns was drawn, and the area under the curve, the optimal threshold and its sensitivity and specificity were calculated.n Results:(1) There were statistically significant differences in total burn area and use of mechanical ventilation of patients between the two groups (n Z=-2.615, n χ2=7.282, n P<0.01). (2) On PID 1, there was statistically significant difference in NLR of patients between the two groups (n Z=-2.414, n P<0.05). On PID 3, there were statistically significant differences in BPC and ΔNLR3 of patients between the two groups (n Z=-2.048, -2.780, n P<0.05 orn P<0.01). On PID 7, there were statistically significant differences in lymphocyte count, BPC, NLR, and ΔNLR7 of patients between the two groups (n Z=-2.248, -2.231, -2.641, -3.669, n P<0.05 orn P<0.01). (3) Binary classification single factor logistic regression analysis showed that the total burn area, mechanical ventilation, BPC and NLR on PID 7, and ΔNLR7 were related to death of patients (odds ratio=1.038, 0.193, 0.990, 1.086, 1.105, 95% confidence interval=1.010-1.067, 0.062-0.598, 0.982-0.998, 1.012-1.165, 1.037-1.178,n P<0.05 orn P<0.01). Binary classification multifactor logistic regression analysis showed that ΔNLR7 was the independent risk factor of death of adult patients with extensive burns (odds ratio=1.090, 95% confidence interval=1.008-1.178,n P<0.05). (4) The optimal threshold of ROC curve of ΔNLR7 for predicting the prognostic death of 97 adult patients with extensive burns was -0.073 4. The sensitivity under the optimal threshold was 65.0%, and the specificity was 78.5%. The area under the ROC curve was 0.776 (95% confidence interval=0.650-0.882,n P<0.01).n Conclusions:Dynamic monitoring of NLR and BPC is of great significance to assist in judging the prognosis of adult patients with extensive burns. ΔNLR7 is an independent predictor of death in adult patients with extensive burns, while PLR can not predict the death of adult patients with extensive burns.