入院时淋巴细胞与单核细胞比值可预测慢性肝衰竭急性发作患者的可能预后。
Lymphocyte-monocyte ratio at admission predicts possible outcomes in patients with acute-on-chronic liver failure.
作者信息
Zhu ShaoMing, Waili Yulituzi, Qi XiaoTing, Chen YueMei, Lou YuFeng
机构信息
aDepartment of Ultrasonography bDepartment of Clinical Laboratory, the First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang cDepartment of Clinical Laboratory, the Sixth Affiliated Hospital of Xinjiang Medical University, Xinjiang dDepartment of Clinical Laboratory, the People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China.
出版信息
Eur J Gastroenterol Hepatol. 2017 Jan;29(1):31-35. doi: 10.1097/MEG.0000000000000767.
BACKGROUND
The lymphocyte-monocyte ratio (LMR) in the peripheral blood is suggested to be a potential biomarker for predicting the clinical outcomes of several diseases. We aimed to evaluate the relative efficiency of LMR for predicting 3-month mortality in patients with acute-on-chronic liver failure (AoCLF).
PATIENTS AND METHODS
In this study, 74 chronic hepatitis B patients, 90 AoCLF patients, and 70 healthy controls were followed up for 4 months. The primary endpoint was 3-month in-hospital mortality. Hematological and virological parameters as well as liver biochemistry were determined using blood samples ordered upon admission. A panel of clinical and biochemical variables were analyzed for potential associations with outcomes using Cox proportional hazards and multiple regression models.
RESULTS
A significantly lower LMR was detected in AoCLF patients than in healthy controls and chronic hepatitis B groups (both P=0.001). The LMR inversely correlated with model for end-stage liver disease scores, and a lower LMR was associated with increased 3-month mortality. Multivariate analysis suggested that both LMR and model for end-stage liver disease scores were independent predictors of 3-month mortality (P<0.01).
CONCLUSION
A low LMR measured at admission is predictive of a poor prognosis in AoCLF patients.
背景
外周血淋巴细胞与单核细胞比值（LMR）被认为是预测多种疾病临床结局的潜在生物标志物。我们旨在评估LMR预测慢性肝衰竭急性发作（AoCLF）患者3个月死亡率的相对效能。
患者与方法
本研究对74例慢性乙型肝炎患者、90例AoCLF患者和70例健康对照进行了4个月的随访。主要终点为3个月内的住院死亡率。入院时采集血样测定血液学、病毒学参数以及肝脏生化指标。使用Cox比例风险模型和多元回归模型分析一系列临床和生化变量与结局之间的潜在关联。
结果
AoCLF患者的LMR显著低于健康对照和慢性乙型肝炎组（均P=0.001）。LMR与终末期肝病模型评分呈负相关，较低的LMR与3个月死亡率增加相关。多变量分析表明，LMR和终末期肝病模型评分均为3个月死亡率的独立预测因素（P<0.01）。
结论
入院时测得的低LMR预示AoCLF患者预后不良。
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