肝脏 ›› 2019, Vol. 24 ›› Issue (2): 130-132.

• 论著 • 上一篇    下一篇

外周血中性粒细胞与淋巴细胞数的比值预测慢加急性肝衰竭疾病进展和临床转归的研究

关菁, 徐玉敏, 冼永超, 黄成军, 赖荣陶, 王晓琳, 谢敬东, 蔡伟, 谢青   

  1. 541002 桂林市第三人民医院肝病科(关菁,冼永超,黄成军);上海交通大学医学院附属瑞金医院感染科(徐玉敏,赖荣陶,王晓琳,谢敬东,蔡伟,谢青)
  • 收稿日期:2018-08-22 发布日期:2020-04-10
  • 通讯作者: 徐玉敏,Email: xym121@163.com
  • 基金资助:
    上海市公共卫生三年行动计划重点学科建设项目传染病与卫生微生物学(15GWZK0102);国家自然科学基金面上项目(81670569);上海市卫生局面上项目(201540038)

The prognostic value of peripheral blood neutrophil-to-lymphocyte ratio in acute-on-chronic liver failure

GUAN Jing, XU Yu-min, XIAN Yong-chao, HUANG Cheng-jun, LAI Rong-tao, WANG Xiao-lin, XIE Jing-dong, CAI Wei, XIE Qing   

  • Received:2018-08-22 Published:2020-04-10
  • Contact: XU Yu-min . Email: xym121@163.com

摘要: 目的 探讨外周血中性粒细胞与淋巴细胞数比值(NLR)对慢加急性肝衰竭(ACLF)疾病进展和临床转归的预测作用。方法 回顾性分析2013年至2017年上海交通大学医学院附属瑞金医院感染科收治的174例ACLF患者的临床资料,根据患者转归,分为生存组及死亡组,分析两组间外周血NLR值的差异。计量资料组间比较采用单因素方差分析及t检验,计数资料组间比较采用χ2检验,通过单因素及多因素logistic回归分析探讨影响疾病进展的因素。结果 生存组的NLR值(2.45±1.16)明显低于死亡组(5.55±3.60),差异有统计学意义(P<0.01)。随着NLR值的逐渐增加,死亡率增高,通过单因素和多因素回归分析得出,NLR和凝血酶原时间是疾病进展的主要影响因素(P<0.01)。结论 外周血NLR可以预测早期风险较高的ACLF患者死亡率。

关键词: 乙肝, 慢加急性肝衰竭, 中性粒细胞, 淋巴细胞, 中性粒细胞淋巴细胞比值

Abstract: Objective To investigate the predictive value of neutrophil-to-lymphocyte ratio (NLR) on the progression and clinical outcome of acute-on-chronic liver failure (ACLF).Methods The clinical data of 174 cases of ACLF from 2013 to 2017 in the Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. According to clinical outcome, patients were divided into the survival group and the death group. NLR was compared between the 2 groups. Continuous data were analyzed using univariate analysis and t-test, and categorical data were analyzed using ?2-test. Univariate and multivariate logistic regression analyses were applied to investigate the factors related to disease progression.Results NLR of the survival group (2.45±1.16) was significantly lower than that of the death group (5.55±3.60), which increased gradually with increased mortality. NLR and prothrombin time were the main affecting factors for disease progression (P<0.001). There was a significant difference in baseline NLRs between the survival group and death group (2.45±1.16 vs. 5.55±3.60, P<0.001).Conclusion Peripheral blood NLR can predict early death risk in patients with ACLF.

Key words: Hepatitis B, Acute-on-chronic liver failure, Neutrophil-to-lymphocyte ratio