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全身免疫炎症指数联合中性粒细胞与淋巴细胞比值对慢性重型肝炎患者预后的预测作用

Predictive effect of systemic immune inflammatory index combined with neutrophil-to-lymphocyte ratio on prognosis of patients with acute-on-chronic liver failure.

作者信息

He Xinchun, Lin Yihe, Qiu Hanyu, Wang Xiaofang, Zhu Baining

机构信息

Department of Infectious Disease, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University) Changsha 410005, Hunan, P. R. China.

出版信息

Am J Transl Res. 2023 Dec 15;15(12):6841-6848. eCollection 2023.

Abstract

OBJECTIVE

To explore the predictive effect of systemic immune inflammatory index (SII) combined with neutrophil-to-lymphocyte ratio (NLR) on prognosis of acute-on-chronic liver failure (ACLF) patients.

METHODS

A retrospective analysis was conducted on the data of 160 patients diagnosed with hepatitis B virus (HBV)-ACLF in Hunan Provincial People's Hospital from June 2022 to June 2023. The patients were divided into a survival group and a death group based on their survival status within 90 days after admission. General data, laboratory indicators, and complications were recorded. The risk factors affecting prognosis of HBV-ACLF patients and the correlation between NLR, SII, and model for end-stage liver disease (MELD) score were analyzed, and the predictive effect of NLR and SII on prognosis was evaluated.

RESULTS

Compared to the survival group, the age, MELD score, and incidence of infection of the death group were higher, and the expression levels of total bilirubin, aspartate aminotransferase, serum creatinine, white blood count, neutrophil, NLR, SII, and international normalized ratio were increased, while the expression levels of alanine aminotransferase, platelets and lymphocytes were decreased (all <0.05). NLR, SII and MELD score were all risk factors affecting the prognosis of HBV-ACLF patients (all <0.001). There was a positive correlation between NLR, SII and MELD score (<0.001). SII combined with NLR showed good performance in predicting the prognosis within 90 days after admission in ACLF patients.

CONCLUSION

SII combined with NLR has a good prognostic effect on ACLF patients.

摘要

目的

探讨全身免疫炎症指数(SII)联合中性粒细胞与淋巴细胞比值(NLR)对慢性重型肝炎急性发作(ACLF)患者预后的预测作用。

方法

回顾性分析2022年6月至2023年6月在湖南省人民医院确诊为乙型肝炎病毒(HBV)-ACLF的160例患者的数据。根据患者入院后90天内的生存情况分为生存组和死亡组。记录一般资料、实验室指标及并发症。分析影响HBV-ACLF患者预后的危险因素以及NLR、SII与终末期肝病模型(MELD)评分之间的相关性,并评估NLR和SII对预后的预测作用。

结果

与生存组相比,死亡组患者年龄、MELD评分及感染发生率更高,总胆红素、天冬氨酸转氨酶、血清肌酐、白细胞计数、中性粒细胞、NLR、SII及国际标准化比值的表达水平升高,而丙氨酸转氨酶、血小板及淋巴细胞的表达水平降低(均P<0.05)。NLR、SII及MELD评分均为影响HBV-ACLF患者预后的危险因素(均P<0.001)。NLR、SII与MELD评分之间呈正相关(P<0.001)。SII联合NLR在预测ACLF患者入院后90天内的预后方面表现良好。

结论

SII联合NLR对ACLF患者具有良好的预后预测作用。

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