Silchar Medical College and Hospital, Silchar.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
Cirrhosis is currently the 11th leading cause of death, accounting for 1.16 million deaths. Cirrhosis of the liver is usually understood to be an end-stage process in which healthy normal liver tissue is replaced by aberrant connective tissue, resulting in nodule formation. Most of the times, cirrhosis may remain clinically asymptomatic until decompensated. Systemic inflammation is now thought to have a critical role in the progression of liver injury. As a result, the adoption of a scoring system in primary care to anticipate the outcome and severity of the cirrhotic process is required since it may be utilized to initiate quick and further assessment. It is emphasized that numerous scoring systems, such as the Child-Turcotte Pugh score, which consists of five variables (bilirubin level, albumin, INR, ascites, and hepatic encephalopathy), can be used to predict the severity of liver failure. Inflammatory markers play a role in the etiology of liver disease. NLR, which is a widely available and inexpensive biomarker of systemic inflammation, can be used as a screening tool to predicting occurrence of complication and short-term mortality in patients with cirrhosis of liver. It can also be used as prognostic marker to detect decompensation in these patients.
This study is conducted in 100 cirrhotic patients of age group more than 18 years for duration of one year. Participants are divided into three groups based on Child Turcotte Pugh Score (CTP). Assessment of Neutrophil to Lymphocyte Ratio is done in these groups.
Out of 100 patients,30 patients belong to Child Pugh A, 30 belongs to Child Pugh B, and 40 belongs to Child Pugh C .Child Pugh C had highest mean NLR of 9.28±4.23 as compared to patient belonging to Child Pugh B and C, although no highest threshold level was determined in this study. In Child-Pugh class C patients, the mean NLR in non survivors was 13.25±4.52 as compared to mean NLR of 6.94±1.52 in survivors. Thus an elevated mean NLR is an independent predictor of poor 1-month survival in patients with Child Pugh C.
Based on the study, it can be concluded that NLR and CTP score has a positive correlation. In Child- Pugh class C patients, NLR is an independent predictor of poor 1-month survival.
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）与慢性肝病严重程度的相关性。方法：选取 2018 年 1 月至 2019 年 1 月我院收治的 100 例肝硬化患者作为研究对象，根据 Child-Turcotte-Pugh（CTP）评分将患者分为 A、B、C 三组，比较三组患者 NLR 及其他临床指标的差异，采用多因素 Logistic 回归分析评估影响患者 1 个月死亡率的相关因素。结果：100 例肝硬化患者中，Child-Pugh A 级 30 例，Child-Pugh B 级 30 例，Child-Pugh C 级 40 例。Child-Pugh C 级患者的 NLR 明显高于 Child-Pugh A 级和 Child-Pugh B 级（P<0.05），且 NLR 与 CTP 评分呈正相关（r=0.525，P<0.05）。多因素 Logistic 回归分析显示，NLR 是影响肝硬化患者 1 个月死亡率的独立危险因素（OR=1.064，95%CI：1.011~1.119，P<0.05）。结论：NLR 与 CTP 评分呈正相关，NLR 是影响肝硬化患者 1 个月死亡率的独立危险因素。
