Center of integrative medicine, Beijing Ditan Hospital, Capital Medical University, Beijing.
Traditional Chinese Medicine Department, Nanyang Central Hospital, Henan, China.
Eur J Gastroenterol Hepatol. 2022 May 1;34(5):529-536. doi: 10.1097/MEG.0000000000002368.
Patients with overt hepatic encephalopathy (OHE) have an increased risk of adverse outcomes. However, the relationship between neutrophil to lymphocyte ratio (NLR) and the 30-day risk of death in patients with OHE has not been well evaluated.
We retrospectively analyzed 1301 patients with OHE at Beijing Ditan Hospital between August 2008 and December 2018. After adjustment for major risk factors, Cox regression analysis and restricted cubic splines were used to analyze the relation between NLR and 30-day mortality. The 30-day survival was calculated by Kaplan-Meier method.
All patients were divided into four subgroups on the basis of the quartiles of the baseline NLR distribution (< 2.5, 2.5-4.3, 4.3-7.5, >7.5). The 30-day mortality rates were 7.8%, 12.7%, 19.5% and 34.1%, respectively (P < 0.001). Compared with the lowest quartile, the increase in the NLR was associated with an increase risk of 30-day mortality after multivariable adjustment (NLR 2.5-4.3: adjusted hazard ratio [AHR], 1.17 (95% confidence interval [CI], 0.70-1.95); NLR 4.3-7.5: AHR, 1.58 (95% CI, 1.01-2.47); NLR > 7.5: AHR, 2.32 (95% CI, 1.50-3.57). A nonlinear association between NLR and the adjusted probability of 30-day mortality was observed. Elevated NLR was correlated with increased 30-day mortality in patients with OHE across different subgroups (HR >1.0).
An elevated NLR is independently associated with a higher risk of 30-day mortality in patients with OHE.
显性肝性脑病（OHE）患者的不良预后风险增加。然而，中性粒细胞与淋巴细胞比值（NLR）与 OHE 患者 30 天死亡风险之间的关系尚未得到很好的评估。
我们回顾性分析了 2008 年 8 月至 2018 年 12 月期间在北京地坛医院就诊的 1301 例 OHE 患者。在调整了主要危险因素后，采用 Cox 回归分析和限制性立方样条分析 NLR 与 30 天死亡率之间的关系。通过 Kaplan-Meier 方法计算 30 天生存率。
根据基线 NLR 分布的四分位数（<2.5、2.5-4.3、4.3-7.5、>7.5），所有患者分为四组。30 天死亡率分别为 7.8%、12.7%、19.5%和 34.1%（P<0.001）。与最低四分位数相比，NLR 升高与多变量调整后的 30 天死亡率升高相关（NLR 2.5-4.3：调整后的危险比[AHR]，1.17（95%置信区间[CI]，0.70-1.95）；NLR 4.3-7.5：AHR，1.58（95% CI，1.01-2.47）；NLR>7.5：AHR，2.32（95% CI，1.50-3.57）。NLR 与调整后 30 天死亡率的概率之间存在非线性关联。在不同亚组中，升高的 NLR 与 OHE 患者 30 天死亡率的增加相关（HR>1.0）。
NLR 升高与 OHE 患者 30 天死亡率升高独立相关。
