目的 探讨中性粒细胞/血小板比值（NPR）联合C反应蛋白（CRP）在下肢动脉硬化闭塞症（ASO）患者预后中的预测价值。 方法 回顾性分析2020年1月至2024年2月复旦大学附属中山医院（厦门）重症医学科收治的209例下肢ASO患者的临床资料。根据患者本次住院预后情况分为生存组和死亡组。计算入重症医学科当天的NPR并收集该日的CRP，比较两组NPR、CRP及NPR联合CRP的差异。通过受试者工作特征曲线（ROC）分析NPR、CRP及NPR联合CRP对下肢ASO患者预后的预测价值，根据NPR联合CRP的ROC曲线的截断值将患者分成两组，使用Kaplan-Meier法对两组患者进行生存分析。 结果 生存组患者的NPR、CRP、谷丙转氨酶、谷草转氨酶、肌酐、B型钠尿肽、肌钙蛋白、降钙素原及合并肾脏病比例明显低于死亡组（P < 0.05）；白蛋白明显高于死亡组（P < 0.05）。二元logistic回归分析结果显示，NPR、CRP、NPR联合CRP、合并肾脏病比例是影响患者生存预后的独立危险因素。ROC曲线结果显示，NPR、CRP、NPR联合CRP曲线下面积分别为0.648、0.812、0.828，其中CRP、NPR联合CRP具有统计学意义（P < 0.05）。与单独NPR或CRP对比，NPR联合CRP具有更好的预测价值。根据NPR联合CRP的ROC曲线，通过最大约登指数确定截断值为0.029，依据截断值将患者分为高NPR + CRP组和低NPR + CRP组。通过Kaplan-Meier生存曲线对两组患者住院期间的生存率进行分析，结果显示，低NPR + CRP组患者的生存率明显高于高NPR + CRP组（P = 0.001）。 结论 NPR联合CRP与下肢ASO患者预后相关，可作为下肢ASO患者预后的有效预测指标。

Objective To investigate the prognostic significance of the neutrophil-to-platelet ratio （NPR） in combination with C-reactive protein （CRP） in patients with lower extremity arteriosclerosis obliterans （ASO）. Methods A retrospective analysis was conducted on the clinical data of 209 patients with lower extremity ASO admitted to the Department of Critical Care Medicine at Zhongshan Hospital Affiliated to Fudan University （Xiamen） between January 2020 and February 2024. Patients were categorized into either the survival group or the death group based on their in-hospital prognosis. The NPR was calculated on the day of ICU admission， as was the level of CRP. Differences in NPR， CRP， and the combination of NPR and CRP between the two groups were then compared. The prognostic value of NPR， CRP， and their combined use for predicting outcomes in patients with lower extremity ASO was evaluated using receiver operating characteristic （ROC） curve analysis. Based on the optimal cutoff value derived from the ROC curve for the combination of NPR and CRP， patients were divided into two groups. Kaplan-Meier survival analysis was subsequently performed to assess differences in survival outcomes between these two groups. Results The levels of NPR， CRP， alanine aminotransferase， aspartate aminotransferase， creatinine， B-type natriuretic peptide， troponin， and procalcitonin， as well as the proportion of patients with kidney disease in the survival group， were significantly lower than those in the death group， and the differences were statistically significant （P < 0.05）. The albumin level in the survival group was significantly higher than that in the death group， with a statistically significant difference （P < 0.05）. Binary logistic regression analysis revealed that NPR， CRP， the combination of NPR and CRP， and the presence of comorbid kidney disease were independent risk factors influencing patient survival prognosis. ROC curve analysis showed that the areas under the curve （AUC） for NPR， CRP， and the combination of NPR and CRP were 0.648， 0.812， and 0.828， respectively. Both CRP and the combination of NPR and CRP demonstrated statistically significant （P < 0.05）. Compared with either NPR or CRP alone， their combined use showed improved predictive performance. Based on the ROC curve for the combination of NPR and CRP， the optimal cutoff value was determined as 0.029 using the maximum Youden Index. Patients were then divided into high and low NPR + CRP groups according to this cutoff. Kaplan-Meier survival analysis revealed that the in-hospital survival rate in the low NPR + CRP group was significantly higher than that in the high NPR + CRP group， and the difference in survival between the two groups was statistically significant （P = 0.001）. Conclusion NPR combined with CRP is associated with the prognosis of patients with lower extremity ASO and may serve as an effective predictive indicator for their clinical outcomes.