中性粒细胞与淋巴细胞比值与乙型肝炎相关性慢加急性肝衰竭疾病进展的临床研究  

Clinical study of neutrophil-lymphocyte ratio and disease progression in patients with HBV-related acute-on-chronic liver failure

作　　者：李元元[1] 耿华[1] 于双杰[1] 张政[1] 吕飒[1] 陈黎明[1] 王福生[1] 

机构地区：[1]解放军第三〇二医院感染性疾病诊疗与研究中心,北京100039

出　　处：《胃肠病学和肝病学杂志》2016年第4期411-414,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：三○二医院院内科题(YNKT2013023);首都临床特色应用研究与成果推广(Z151100004015014)

摘　　要：目的研究中性粒细胞与淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)在慢性乙型肝炎(chronic hepatitis B,CHB)基础上慢加急性肝衰竭(acute-on-chronic liver failure,ACLF)患者中的临床诊断价值。方法 CHB基础上的ACLF患者57例,CHB患者30例,健康对照者(healthy controls,HC)20名。采用血细胞分析仪检测外周血中性粒细胞及淋巴细胞数目并进行统计学分析。结果ACLF患者NLR显著高于HC(P=0.025)和CHB患者(P<0.001),且在早期、中期、晚期患者中逐渐升高。相关性分析发现,ACLF患者NLR与凝血酶原活动度(PTA)呈负相关(r=-0.812,P<0.001),与DBil和MELD分值呈正相关(r=0.594,0.718,P<0.001),而与TBil和HBV病毒载量之间无相关性(P>0.05)。虽然NLR与ALT呈正相关(r=0.454,P<0.05),但各个分期之间不再具有相关性。结论 NLR逐渐升高可能表示ACLF患者临床疾病呈进行性加重。Objective To evaluate the relationship between neutrophil-lymphocyte ratio（NLR） and disease progression in patients with HBV-related acute-on-chronic liver failure（ ACLF）. Methods Fifty-seven ACLF patients,30 chronic hepatitis B（ CHB） patients and 20 healthy controls（ HC） were enrolled in this study. The peripheral blood was analyzed by an automated differential blood count machine. Results The NLR was significantly higher in ACLF patients than that in the HC（ P = 0. 025） and CHB patients（ P〈0 001）. For ACLF patients,the NLR increased from early stage to intermediate stage and reached the highest at late stage. Moreover,statistical analysis indicated that NLR negatively correlated with PTA value（ r =- 0. 812,P〈0 001）,and positively correlated with DBil and MELD score（ model of end-stage liver disease）（ r = 0. 594,0. 718,P〈0 001）. There were no correlations between NLR and TBil / HBV viral load（ P〉0 05）. Conclusion Increase of NLR may correlate with disease progression in CHB patients with ACLF.

关 键 词：慢加急性肝衰竭 中性粒细胞与淋巴细胞比值 乙型肝炎病毒 疾病进展 

分 类 号：R512.62[医药卫生—内科学]