Chinese Hepatolgy ›› 2022, Vol. 27 ›› Issue (12): 1331-1334.

• Other Liver Diseases • Previous Articles     Next Articles

Predictive value of NLR in severity and risk of liver injury in patients with acute pancreatitis

WANG Lei1, WANG Zhao-wei1, XU Zhi-hua2   

  1. 1. Suzhou Science&Technology Town Hospital, Jiangsu 215153, China;
    2. The First Affiliated Hospital of Soochow University, Jiangsu 215006, China
  • Received:2022-05-27 Published:2023-01-30
  • Contact: WANG Zhao-wei, Email:mikaimmonen_qq@sina.com

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Abstract: Objective To investigate the predictive value of neutrophil/lymphocyte ratio (NLR) in the severity of acute pancreatitis (AP) and liver injury.Methods The clinical data of 92 patients with AP were collected and analyzed retrospectively. They were divided into severe, moderate and mild group according to the severity of the disease, and the general situation, NLR value and leukocyte count of the three groups at different time points were compared. According to whether there was liver injury (liver injury group and no liver injury group), we compared the changes of NLR value between the two groups, drew ROC curve, and analyzed the prediction efficiency of NLR on the severity of the disease and liver injury.Results There were significant differences in white blood cell (WBC), neutrophil count, NLR immediately after admission, NLR 48h after admission and lymphocyte count among the three groups (P<0.05). NLR immediately after admission in severe group was significantly higher than that in moderate group [15.24 (8.01) vs 11.20 (4.96), P<0.05]. There were no significant difference in WBC [(14.26 ± 4.39)×109/L vs (15.32±5.79)×109/L], neutrophil count [11.96(5.24)×109/L vs 13.05(5.70)×109/L], lymphocyte count [1.08(0.98)×109/L vs 0.85(0.32)×109/L] and NLR 48h after admission [7.82(4.66) vs 8.21(6.54)] between moderate group and severe group (P>0.05). Compared with the non liver injury group, the WBC [(16.32±4.63)×109/L vs (11.83±3.56)×109/L ], neutrophil count [13.30(8.20)×109/L vs 9.36(4.56)×109/L ], NLR immediately after admission [16.12(7.02) vs 6.54(3.96)] and NLR 48 h after admission [8.26(5.01) vs 8.26(5.01)] in the liver injury group were higher, and the lymphocyte count was lower [0.84(0.25)×109/L vs 1.40(1.01)×109/L, P<0.05]. ROC curve analysis showed that NLR had the highest predictive efficacy for non mild AP and liver injury immediately after admission (AUC = 0.845, 0.877, the best cut-off values were 7.85 and 10.67), followed by NLR for 48 hours after admission (AUC = 0.831, 0.821, the best cut-off values were 4.78 and 5.92).Conclusion The levels of neutrophils and lymphocytes are closely related to the severity of AP and the occurrence of liver injury. Monitoring the NLR value at admission has high prediction accuracy for the severity of AP and liver injury.

Key words: Acute pancreatitis, Neutrophil/lymphocyte ratio, Liver injury, Severity