Li J N, Sun M Y, Li H, Tang S H
College of Medicine, Southwest JiaoTong University, Chengdu 610083, China Department of Gastroenterology, the General Hospital of Western Theater Command, Chengdu 610083, China.
Department of Gastroenterology, the General Hospital of Western Theater Command, Chengdu 610083, China.
Zhonghua Gan Zang Bing Za Zhi. 2022 Jun 20;30(6):644-648. doi: 10.3760/cma.j.cn501113-20210726-00361.
To investigate the predictive value of the monocyte-to-lymphocyte ratio (MLR) for survival in patients with hepatitis B-related acute-on-chronic liver failure (HBV-ACLF). 92 cases with HBV-ACLF who were admitted to the General Hospital of Western Theater Command from October 2014 to October 2017 were selected. Clinical indicators were retrospectively collected, and their survival condition was followed up for 90 days, with the end point as death or liver transplantation. MLR levels predictive value among patients after 90 days of involvement was compared by analyzing the differences between the survival and death groups and its correlation with various indicators of liver function for prognosis. 92 cases were included in this study, with a 90-day survival rate of 52% (48/92), and a mortality rate of 48% (44/92). MLR for survival and death groups were 0.520 (0.310, 0.828) and 0.740 (0.440, 1.120), respectively. MLR level was significantly higher in the death than survival group (<0.05). Receiver operating characteristic curve (ROC) analysis showed that the area under the ROC curve (AUC) and 95% confidence interval for the survival group was 0.640 (0.527-0.754). The cutoff value for MLR was 0.399 at which the sensitivity and specificity were 0.864 and 0.396, respectively. Survival analysis showed that the 90-day survival rate was significantly lower in the high MLR group than corresponding low MLR group (=0.011). Logistic multivariate regression analysis showed that after adjusting for other factors, MLR level was an independent prognostic factor in patients with HBV-ACLF. MLR can be used as a potential prognostic indicator for patients with HBV-ACLF, and its clinical value needs to be verified by large-scale prospective randomized trials.
探讨单核细胞与淋巴细胞比值（MLR）对乙型肝炎相关慢加急性肝衰竭（HBV-ACLF）患者生存的预测价值。选取2014年10月至2017年10月在西部战区总医院收治的92例HBV-ACLF患者。回顾性收集临床指标，并对其生存状况进行90天随访，终点为死亡或肝移植。通过分析生存组与死亡组之间的差异及其与肝功能各项指标的相关性，比较MLR水平在干预90天后对患者的预测价值。本研究共纳入92例患者，90天生存率为52%（48/92），死亡率为48%（44/92）。生存组和死亡组的MLR分别为0.520（0.310，0.828）和0.740（0.440，1.120）。死亡组的MLR水平显著高于生存组（<0.05）。受试者工作特征曲线（ROC）分析显示，生存组的ROC曲线下面积（AUC）及95%置信区间为0.640（0.527 - 0.754）。MLR的截断值为0.399，此时灵敏度和特异度分别为0.864和0.396。生存分析显示，高MLR组的90天生存率显著低于相应的低MLR组（=0.011）。Logistic多因素回归分析显示，在调整其他因素后，MLR水平是HBV-ACLF患者的独立预后因素。MLR可作为HBV-ACLF患者潜在的预后指标，其临床价值有待大规模前瞻性随机试验验证。
