NLR和HBD-1与M30对乙型肝炎病毒感染相关慢加急性肝衰竭患者人工肝治疗短期预后的预测价值  

Values of NLR,HBD-1 and M30 in prediction of short-term prognosis of patients with hepatitis B virus infection-related chronic plus acute liver failure treated with artificial liver

作　　者：崔雪曼 杨赞儒 付海燕 刘思嘉 钱洪林 CUI Xue-man;YANG Zan-ru;FU Hai-yan;LIU Si-jia;QIAN Hong-lin(First Affiliated Hospital of Jinzhou Medical University,Jinzhou,Liaoning 121oo0,China)

机构地区：[1]锦州医科大学附属第一医院传染科,辽宁锦州121000 [2]锦州医科大学附属第一医院骨外科创伤一病区,辽宁锦州121000 [3]锦州医科大学附属第一医院重症医学科,辽宁锦州121000

出　　处：《中华医院感染学杂志》2024年第11期1621-1625,共5页Chinese Journal of Nosocomiology

基　　金：辽宁省科研基金资助项目(2021LK03101)。

摘　　要：目的 探讨乙型肝炎病毒(HBV)感染相关慢加急性肝衰竭(ACLF)患者人工肝治疗中性粒细胞/淋巴细胞比值(NLR)和人β防御素(HBD-1)与M30及其对短期预后的预测价值.方法 选取锦州医科大学附属第一医院2020年2月-2023年2月收治的119例行人工肝治疗的HBV感染相关ACLF患者为研究对象,根据入院后90 d存活情况分为存活组83例和死亡组36例;归纳入工肝治疗的HBV感染相关ACLF短期预后的影响因素;检测NLR、HBD-1和M30;采用受试者工作特征(ROC)曲线分析NLR、HBD-1、M30对人工肝治疗的HBV感染相关ACLF短期预后预测价值.结果 年龄、肌酐(Cr)、国际标准化比值(INR)是人工肝治疗的HBV感染相关ACLF短期预后死亡的影响因素(P<0.05);死亡组外周血NLR、血清HBD-1、M30均高于存活组(P<0.05);绘制ROC曲线获得NLR、HBD-1、M30单独及联合检测诊断人工肝治疗的HBV感染相关ACLF短期预后的曲线下面积(AUC)分别为0.790、0.696、0.776和0.918;其中,联合诊断的AUC高于各项单独检测,且联合检测的敏感度和特异度为80.60%,86.70%.结论 人工肝治疗的HBV感染相关ACLF短期预后存活患者外周血NLR、血清HBD-1、M30呈低表达;联合检测NLR、HBD-1、M30有助于诊断人工肝治疗的HBV感染相关ACLF短期预后.OBJECTIVE To investigate the changes in neutrophil/lymphocyte ratio(NLR),humanβ-defense hormone(HBD-1),and M30 in patients with hepatitis B virus(HBV)infection-related ACLF treated with of artificial liver,and their predictive value of short-term prognosis.METHODS A total of 119 patients with HBV infection-associated ACLF who received artificial liver treatment in the First Affiliated Hospital of Jinzhou Medical University from Feb.2020 to Feb.2023 were selected and divided into 83 cases in the survival group and 36 cases in the death group according to their survival 90 days after admission.The factors influencing the short-term prognosis of HBV infection-associated ACLF treated with artificial liver were summarized.The neutrophil to lymphocyte ratio(NLR),HBD-1 and M30 were detected.The predictive value of NLR,HBD-1 and M30 on the short-term prognosis of HBV infection-associated ACLF treated with artificial liver was analyzed by using the receiver operating characteristics(ROC)curve.RESULTS Age,creatinine(Cr)and international normalized ratio(INR)were the factors affecting the short-term prognosis and death of HBV infection-associated ACLF treated with artificial liver(P<0.05).Peripheral blood NLR,serum HBD-1 and M30 in the death group were higher than those in the survival group(P<0.05).The area under the curve(AUC)of NLR,HBD-1 and M30 alone and combined detection obtained by plotting ROC curves for the diagnosis of short-term prognosis of HBV infection-associated ACLF treated with artificial liver were 0.790,0.696,0.776 and 0.918,respectively,wherein,the AUC of combined diagnosis was higher than that of each single detection,and the sensitivity and specificity of combined detection were 80.60%and 86.70%.CONCLUSION The expression of NLR,serum HBD-1 and M30 in peripheral blood of patients with HBV infection-associated ACLF treated with artificial liver was decreased.The combined detection of NLR,HBD-1 and M30 would help to diagnose the short-term prognosis of HBV infection-associated ACLF treated with artificia

关 键 词：乙型肝炎病毒感染相关慢加急性肝衰竭 人工肝 短期预后 中性粒细胞/淋巴细胞比值 人β防御素 M30 受试者工作特征曲线 危险因素 

分 类 号：R512.62[医药卫生—内科学]