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血小板与单核细胞比值作为预测乙型肝炎病毒相关失代偿期肝硬化预后的新指标。

Platelet-to-Monocyte Ratio as a Novel Promising Agent for the Prognosis of Hepatitis B Virus-Associated Decompensated Cirrhosis.

机构信息

Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, Jiangsu, China.

出版信息

Can J Gastroenterol Hepatol. 2023 Jul 14;2023:6646156. doi: 10.1155/2023/6646156. eCollection 2023.

Abstract

AIM

The present study aimed at investigating associations of the platelet-to-monocyte ratio (PMR), a novel hematological indicator of inflammatory responses with 30-day outcomes in patients with HBV-associated decompensated cirrhosis (HBV-DeCi).

METHODS

We recruited 329 patients with HBV-DeCi for this retrospective study and extracted baseline clinical data and laboratory characteristics from medical records. Univariate and multivariate analyses were performed to determine major factors influencing 30-day mortality. Receiver operating characteristic curve analysis was performed to compare the predictive values of prognostic markers.

RESULTS

During the 30-day follow-up period, 21 (6.4%) patients died. The PMR was significantly different between nonsurvivors and survivors. Lower PMR was found to be associated with an increased risk of 30-day mortality, and PMR (odds ratio: 1.011; 95% CI: 1.003-1.019; =0.005) was found to be an independent predictor of 30-day mortality in patients with HBV-DeCi with a significant predictive value (AUC = 0.826, 95% CI: 0.781-0.865). The combination of PMR and MELD score could improve prognostic accuracy in these patients (AUC = 0.911, 95% CI: 0.876-0.940).

CONCLUSIONS

Our results demonstrate that low PMR may be an independent predictor of 30-day mortality in patients with HBV-DeCi, and combined with the MELD score, it may be useful to complement other conventional measures to enable effective management of these patients.

摘要

目的

本研究旨在探讨血小板与单核细胞比值(PMR)这一反映炎症反应的新型血液学指标与乙型肝炎相关失代偿性肝硬化(HBV-DeCi)患者 30 天结局的关系。

方法

我们对 329 例 HBV-DeCi 患者进行了这项回顾性研究,并从病历中提取了基线临床数据和实验室特征。进行单因素和多因素分析以确定影响 30 天死亡率的主要因素。进行受试者工作特征曲线分析以比较预后标志物的预测价值。

结果

在 30 天随访期间,有 21 例(6.4%)患者死亡。死亡患者与存活患者的 PMR 差异显著。较低的 PMR 与 30 天死亡风险增加相关,PMR(比值比:1.011;95%置信区间:1.003-1.019;=0.005)是 HBV-DeCi 患者 30 天死亡的独立预测因素,具有显著的预测价值(AUC=0.826,95%置信区间:0.781-0.865)。PMR 与 MELD 评分的联合可以提高这些患者的预后准确性(AUC=0.911,95%置信区间:0.876-0.940)。

结论

我们的研究结果表明,低 PMR 可能是 HBV-DeCi 患者 30 天死亡率的独立预测因素,与 MELD 评分相结合,可能有助于补充其他常规措施,从而有效管理这些患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ed5/10361825/14685dd5c9fd/CJGH2023-6646156.001.jpg

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