Department of Interventional Radiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
Department of Interventional Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
Biotechnol Genet Eng Rev. 2024 Nov;40(3):1791-1805. doi: 10.1080/02648725.2023.2196824. Epub 2023 Apr 3.
The neutrophil-to-lymphocyte ratio (NLR) has been shown to predict patient outcomes in various disorders. This study was carried out to evaluate the value of NLR in predicting mortality in decompensated cirrhosis patients having transjugular intrahepatic portosystemic shunt (TIPS). The end-stage liver disease model (MELD) is a scoring system to evaluate the liver function reserve. Retrospective investigation was conducted on the clinical information of 244 decompensated cirrhosis individuals with a MELD score ≤15 who underwent TIPS production at two academic medical centres between January 2017 and August 2021. The main result was 12-month post-TIPS mortality. The area under the receiver operating characteristic curve (AUC) was used to investigate the predictive potential of prognostic markers correlated with 12-month mortality using a logistic regression approach. To minimize the effects of potential factors, a 1:2 propensity score matching (PSM) was carried out. The non-surviving group had 21 (8.6%) patients who passed away within 12mo, while the surviving group included 223 (91.4%) patients who survived for more than 12mo. According to the multivariate analyses, NLR>4.8 was an independent prognostic factor of 12-month mortality after PSM analysis (OR=3.4, 95%CI, 1.052-10.985, =0.041). In comparison to the non-surviving group, the proportion of NLR-high (>4.8) cells in the surviving group were considerably greater (71.4%vs.38.1%, =0.017). Whether Unmatched group or the Matched group, NLR exhibited the highest diagnostic performance (AUCs of 0.646 and 0.667, respectively, <0.05). The NLR is a reasonable and effective indicator of 12-month mortality in decompensated cirrhosis patients with a MELD ≤15 receiving TIPS.
中性粒细胞与淋巴细胞比值(NLR)已被证明可预测各种疾病患者的预后。本研究旨在评估 NLR 在预测接受经颈静脉肝内门体分流术(TIPS)治疗的失代偿性肝硬化患者死亡率中的价值。终末期肝病模型(MELD)是一种评估肝功能储备的评分系统。回顾性分析了 2017 年 1 月至 2021 年 8 月期间在两个学术医疗中心接受 TIPS 治疗的 244 名 MELD 评分≤15 的失代偿性肝硬化患者的临床资料。主要结果是 TIPS 后 12 个月的死亡率。使用逻辑回归方法,通过受试者工作特征曲线(ROC)下面积(AUC)来评估与 12 个月死亡率相关的预后标志物的预测潜力。为了最小化潜在因素的影响,进行了 1:2 倾向评分匹配(PSM)。非存活组有 21 例(8.6%)患者在 12mo 内死亡,而存活组包括 223 例(91.4%)患者存活时间超过 12mo。根据多变量分析,NLR>4.8 是 PSM 分析后 12 个月死亡率的独立预后因素(OR=3.4,95%CI,1.052-10.985, =0.041)。与非存活组相比,存活组中 NLR 高(>4.8)细胞的比例明显更高(71.4%vs.38.1%, =0.017)。无论是未匹配组还是匹配组,NLR 均表现出最高的诊断性能(AUC 分别为 0.646 和 0.667,均<0.05)。NLR 是预测 MELD≤15 的接受 TIPS 治疗的失代偿性肝硬化患者 12 个月死亡率的合理且有效的指标。