论文部分内容阅读
目的 探讨慢加急性肝衰竭患者中性粒细胞/淋巴细胞比值(NLR)对预后的影响.方法 收集147例诊断为慢加急性肝衰竭患者肝功能、血常规、肌酐、国际化标准比(INR),并计算其NLR、终末期肝病模型(MELD)评分、Child-pugh (CP)评分,分析NLR与CP评分、MELD评分、生存预后之间的关系.结果 慢加急性肝衰竭生存组NLR低于死亡组,差异有统计学意义(P＜0.01));通过关联分析NLR与CP评分(r =0.309,P＜0.001)、MELD评分(r=0.680,P＜0.001)呈正相关;单因素及多因素logistic回归分析表明,NLR升高是慢加急性肝衰竭患者短期死亡的独立危险因素(P＜ 0.01);Kaplan-Meier生存分析证明高水平NLR是慢加急性肝衰竭死亡的重要预测因子(P＜0.01).结论 慢加急性肝衰竭患者NLR普遍升高,且NLR与CP评分、MELD评分呈正相关,是预测慢加急性肝衰竭死亡的重要指标.“,”Objective To investigate the effect of the neutrophil-to-lymphocyte ratio on prognosis of patients with acute-on-chronic liver failure(ACLF).Methods One hundred and forty-seven patients were involved in our study.Liver function,blood routine examination,creatinine,international normalised ratio were measured,and neutrophil-to-lymphocyte ratio (NLR),model for end-stage liver disease (MELD) scores,Child-pugh (CP)scores were calculated.The associations between NLR and MELD scores,CP scores,and prognostic in patients with ACLF were analyzed.Results NLR in survivors was lower than non-survivors,there was significant difference between the two groups(P ＜ 0.001).In correction analysis,NLR ratios were positive corrected with CP scores(r =0.309,P ＜ 0.001),and MELD scores (r =0.680,P ＜ 0.001).According to univariate and multivariate logistic regression analysis,high NLR ratio was the independent factor for short mortality in ACLF.Kaplan-Meier survival analysis demonstrated that NLR was an important predictor of mortality in ACLF.Conclusions NLR is high in patients with ACLF,and NLR is positively corrected with CP scores,and MELD scores.NLR can be an important predictor for mortality in ACLF patients.