Xiang Yang, Mao WeiLin
Department of Endocrinology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
Department of Clinical Laboratory, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, China.
BMC Gastroenterol. 2025 May 26;25(1):404. doi: 10.1186/s12876-025-03991-z.
Hepatitis B virus-associated decompensated cirrhosis (HBV-DC) is recognized as a critical illness with an increased risk of short-term mortality. Neutrophil-derived ratios, including neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-albumin ratio, neutrophil-to-high-density lipoprotein-cholesterol ratio, neutrophil-to-hemoglobin ratio, and neutrophil-to-platelet ratio, have emerged as potential prognostic markers in various liver diseases. The present study aimed to determine the effectiveness of these neutrophil-derived ratios for prediction of mortality in patients with HBV-DC.
We conducted a retrospective analysis of HBV-DC patients at our hospital between April 2022 and April 2024. The study endpoint was the 30-day mortality rate. These neutrophil-derived ratios were calculated from data obtained during routine laboratory tests on admission. Disease severity was assessed using the Model for End-Stage Liver Disease (MELD) score. Multivariate regression analyses and receiver operating characteristic (ROC) curve analyses were conducted.
The study investigated 160 HBV-DC patients, of whom 23 (14.4%) experienced mortality within 30 days. Non-survivors exhibited markedly higher values for neutrophil-derived ratios than survivors. All neutrophil-derived ratios were associated with mortality in univariate analyses, but only NLR and MELD score remained as independent predictors of mortality in multivariate analyses. In the ROC analyses, NLR showed a similar prognostic value to MELD score. Moreover, both NLR and MELD score had high specificity for prediction of mortality in HBV-DC patients.
Among neutrophil-derived ratios, NLR stands out as a simple and reliable predictor of mortality in HBV-DC patients.
乙型肝炎病毒相关失代偿性肝硬化（HBV-DC）被认为是一种严重疾病，短期死亡率风险增加。中性粒细胞衍生比值，包括中性粒细胞与淋巴细胞比值（NLR）、中性粒细胞与白蛋白比值、中性粒细胞与高密度脂蛋白胆固醇比值、中性粒细胞与血红蛋白比值以及中性粒细胞与血小板比值，已成为各种肝脏疾病潜在的预后标志物。本研究旨在确定这些中性粒细胞衍生比值对预测HBV-DC患者死亡率的有效性。
我们对2022年4月至2024年4月期间我院的HBV-DC患者进行了回顾性分析。研究终点为30天死亡率。这些中性粒细胞衍生比值根据入院时常规实验室检查获得的数据计算得出。使用终末期肝病模型（MELD）评分评估疾病严重程度。进行了多变量回归分析和受试者工作特征（ROC）曲线分析。
该研究调查了160例HBV-DC患者，其中23例（14.4%）在30天内死亡。非幸存者的中性粒细胞衍生比值明显高于幸存者。在单变量分析中，所有中性粒细胞衍生比值均与死亡率相关，但在多变量分析中，只有NLR和MELD评分仍然是死亡率的独立预测因素。在ROC分析中，NLR显示出与MELD评分相似的预后价值。此外，NLR和MELD评分对预测HBV-DC患者的死亡率均具有高特异性。
在中性粒细胞衍生比值中，NLR是预测HBV-DC患者死亡率的一个简单可靠的指标。
