外周血NLR联合终末期肝病模型预测乙型肝炎相关慢加急性肝衰竭短期预后价值  

Predictive value of NLR combined with MELD in short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure

作　　者：吴玲[1] 胡长青 刘贞君 张婷婷 WU Ling;HU Chang-qing;LIU Zhen-jun(Department of Infectious Diseases,Anqing Municipal Hospital,The Affiliated Hospital of Anhui Medicine University(Anqing Anhui,246003)China)

机构地区：[1]安徽医科大学附属安庆医院感染科,安徽安庆246000 [2]连云港第一人民医院感染科

出　　处：《中西医结合肝病杂志》2022年第6期540-542,552,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：江苏省博士后科研项目(No.1701010C)。

摘　　要：目的:探讨中性粒细胞/淋巴细胞比值(NLR)联合终末期肝病模型(MELD)对乙型肝炎相关性慢加急性肝衰竭(HBV-ACLF)患者短期预后的预测价值。方法:回顾性分析2014年1月至2020年1月收治的60例HBV-ACLF患者的临床资料,根据患者90 d转归,分为生存组和死亡组,分别应用MELD、NLR、NLR联合MELD对患者进行评分,计算90 d病死率,并通过绘制受试者工作特征(ROC)曲线下面积(AUC)评估NLR联合MELD的短期预后价值。结果:60例HBV-ACLF患者90 d死亡率为71.1%,死亡组患者MELD、NLR联合MELD、NLR的分值中位数分别为32(19~48)、35(23~52)、4(1~12),生存组患者的分值中位数分别为22(14~32)、24(15~33)、1(1~5),组间比较差异有统计学意义(P<0.05)。NLR联合MELD的AUC相对最高,为0.910(0.838~0.983)。结论:NLR联合MELD可用于预测HBV-ACLF患者90 d预后。Objective:To investigate the value of neutrophIL-lymphocyte ratio(NLR) combined with modle for enD-stage liver disease(MELD) in predicting the short-term prognosis of patients with hepatitis B virus-related acute-on chronic liver failure(HBV-ACLF).Methods:A retrospective analysis was performed for the clinical data of 60 from January 2014 to January 2020 in department of infectious diseases, anqing municipal hospital, the affiliated hospital of an hui medicine university, according to the prognosis at 90 days, and these patients were divided into survival group and death group. The scores of MELD,NLR and NLR combined with MELD for patients were calculated. The 90 days mortality of patients was measured.and the area under the ROC curve(AUC) of NLR combined with MELD was used to evaluate the value of NLR combined with MELD in predicting the short-term prognosis of HBV-ACLF patients. Results:60 patients(71.1%)were died within 90 days, The median scores of MELD,MELD-NA and NLR at hospital admission were32(19~48),34(19~69),4(1~12)among patients died within 90 days. And were22(14~32),23(14~43), 1(1~5) among the survival patients, respectively. The scores of MELD,MELD-NA and NLR were significantly different between the survival and death groups(P<0.05). The AUC of the combination of NLR and MELD which was 0.91(95% CI: 0.838-0.983) was the largest. Conclusion:The combined detection of NLR and MELD could predict the 90 days prognosis of HBV-ACLF patients.

关 键 词：乙型肝炎 慢加急性肝衰竭 中性粒细胞/淋巴细胞比值 终末期肝病模型 预后 

分 类 号：R575.3[医药卫生—消化系统]