【目的】评估急性盆腔炎性疾病 （APID） 患者中医证型与中性粒细胞与淋巴细胞计数比值 （NLR） 、降钙素原 （PCT） 、C反应 蛋白 （CRP） 、白细胞介素6 （IL-6） 水平的相关性，从而评估NLR、PCT、CRP、IL-6在APID患者中的诊断意义。【方法】选取符合纳 入标准的110例于2020年1月 ~ 2024年3月在临海市中医院妇科门诊及住院部接受治疗的APID患者，根据中医辨证分型标 准分为热毒炽盛证60例和湿热瘀阻50例，比较不同中医证型的NLR、PCT、CRP、IL-6、炎性包块直径、盆腔积液深度水 平，分析NLR、PCT、CRP、IL-6与炎性包块直径、盆腔积液深度的关系，探讨APID患者预后与NLR、PCT、CRP、IL-6、炎 性包块直径、盆腔积液深度的关系，以及不同中医证型APID患者与NLR、PCT、CRP、IL-6、炎性包块直径、盆腔积液深度 的相关性。【结果】热毒炽盛证患者的NLR、PCT、CRP、IL-6水平及炎性包块直径、盆腔积液深度均明显高于湿热瘀阻证 （P < 0.05或P < 0.01） 。Spearman相关分析结果显示，NLR、PCT、CRP、IL-6水平与炎性包块直径、盆腔积液深度呈正相关 （P < 0.01） 。 Logistic 回归分析结果显示，NLR、PCT、CRP、IL-6水平及炎性包块直径、盆腔积液深度与APID预后呈负相 关 （P < 0.05或P < 0.01） 。多因素Logistic回归分析结果显示，NLR、PCT、CRP、IL-6水平及炎性包块直径、盆腔积液深度与 热毒炽盛证、湿热瘀阻证均呈正相关 （P < 0.05或P < 0.01）。【结论】热毒炽盛证患者NLR、PCT、CRP、IL-6水平高于湿热瘀 阻证，NLR、PCT、CRP、IL-6有可能成为APID中医辨证的潜在生物学指标。

Objective To investigate the correlation between traditional Chinese medicine（TCM）syndrome types and serum level of neutrophil-to-lymphocyte ratio（NLR）， procalcitonin（PCT）， C-reactive protein（CRP）， and interleukin 6（IL-6） in the patients with acute pelvic inflammatory disease（APID）， and to assess the diagnostic value of NLR，PCT，CRP，and IL-6 for APID patients. Methods A total of 110 patients with APID who met the inclusion criteria and were admitted to the Gynecology Outpatient and Inpatient Departments of Linhai Hospital of Traditional Chinese Medicine from January 2020 to March 2024 were selected，and were classified into 60 cases of excessive heat-toxin syndrome and 50 cases of dampness-heat-stasis obstruction syndrome according to the criteria of TCM syndrome differentiation. The levels of serum indicators of NLR， PCT， CRP and IL-6， diameter of inflammatory masses， and depth of pelvic effusion were compared between the two TCM syndrome types，and the correlation of serum indicator levels with inflammatory mass diameter and depth of pelvic effusion was analyzed. Moreover，the correlation of serum indicator levels，diameter of inflammatory masses，and depth of pelvic effusion with the prognosis of APID and their correlation with TCM syndrome types were investigated. Results Levels of serum indicators of NLR， PCT， CRP， and IL-6， inflammatory mass diameter and depth of pelvic effusion in the patients of excessive heat-toxin syndrome were significantly higher than those in the patients of dampness-heat-stasis obstruction syndrome（P < 0.05 or P < 0.01）. Results of Spearman correlation analysis showed that the levels of serum indicators of NLR， PCT， CRP， and IL-6 were positively correlated with the diameter of inflammatory masses and depth of pelvic effusion（P < 0.01）. Results of Logistic regression analysis showed that the serum indicator levels， diameter of inflammatory masses， and depth of pelvic effusion were negatively correlated with APID prognosis（P < 0.05 or P < 0.01）. Results of multivariate logistic regression showed thattheserum indicatorlevels，diameterofinflammatorymassesanddepthofpelviceffusionwerepositively correlated with the excessive heat-toxin syndrome and dampness-heat-stasis obstruction syndrome（P < 0.05 or P < 0.01）. Conclusion The levels of serum NLR， PCT， CRP and IL-6 are higher in the patients of excessive heat-toxin syndrome than those of dampness-heat-stasis obstruction syndrome. Serum NLR，PCT，CRP and IL-6 may serve as the potential biological indicators the TCM syndrome differentiation of APID in clinic.

R271.9

浙江省自然科学基金项目 （编号：2023J011898）