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ABO血型不相容肝移植术后终末期肝硬化患者血液中性粒细胞与淋巴细胞比值的预测价值

The predictive value of blood neutrophil-lymphocyte ratio in patients with end-stage liver cirrhosis following ABO-incompatible liver transplantation.

作者信息

Lin Bingyi, Geng Lei, Zheng Zhiyun, Jia Junjun, Shen Tian, Zhang Jing, Zhou Lin, Zheng Shusen

机构信息

Department of Transplantation Immune Research, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, Hangzhou 310003, China.

Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

出版信息

J Res Med Sci. 2016 Sep 1;21:69. doi: 10.4103/1735-1995.189653. eCollection 2016.

Abstract

BACKGROUND

The study was designed to assess the role of preoperative neutrophil, lymphocyte, and neutrophil-lymphocyte ratio (NLR) in predicting survival outcomes of ABO-incompatible liver transplantation (LT).

MATERIALS AND METHODS

We retrospectively collected the demographic and clinical characteristics of 71 patients with end-stage liver cirrhosis following ABO-incompatible LT in this study. Kaplan-Meier survival analysis and Cox multiple factors regression analysis were performed to determine the independent risk factors from preoperative blood parameters for poor prognosis.

RESULTS

The 1-, 3-, and 5-year overall survival were 94.9%, 80.0%, and 80.0% in the normal NLR group, respectively, and 59.4%, 55,4%, and 55.4% in patients with up-regulated NLR, respectively ( = 0.001). Furthermore, no significant difference was observed on post-LT complications between normal NLR and high-NLR groups. The high NLR was identified as the only independent prognostic risk factor for recipient survival ( = 0.015, 95% confidence interval = 3.573 [1.284-9.943]).

CONCLUSION

The preoperative high NLR could be considered as a convenient and available indicator for selecting ABO-incompatible LT candidates.

摘要

背景

本研究旨在评估术前中性粒细胞、淋巴细胞及中性粒细胞与淋巴细胞比值(NLR)在预测ABO血型不相容肝移植(LT)生存结局中的作用。

材料与方法

本研究回顾性收集了71例ABO血型不相容肝移植术后终末期肝硬化患者的人口统计学和临床特征。采用Kaplan-Meier生存分析和Cox多因素回归分析,以确定术前血液参数中影响预后不良的独立危险因素。

结果

正常NLR组的1年、3年和5年总生存率分别为94.9%、80.0%和80.0%,NLR升高患者的相应生存率分别为59.4%、55.4%和55.4%(P = 0.001)。此外,正常NLR组和高NLR组在肝移植术后并发症方面未观察到显著差异。高NLR被确定为受者生存的唯一独立预后危险因素(P = 0.015,95%置信区间 = 3.573 [1.284 - 9.943])。

结论

术前高NLR可被视为选择ABO血型不相容肝移植受者的一个方便且可用的指标。

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