Lin Huiying, Zheng Mengyao, Huang Yaqin, Zhu Huilin, Zhang Lili, Yang Wenting, Wang Hongjin, Yin Tingting, Zhou Min, Lei Hongtao, Tai Wenlin, Yang Jinhui
Department of Gastroenterology, Second Affiliated Hospital of Kunming Medical University, Kunming, China.
School of Public Health, Kunming Medical University, Kunming, China.
Aliment Pharmacol Ther. 2025 Sep;62(6):646-655. doi: 10.1111/apt.70233. Epub 2025 Jun 23.
Primary biliary cholangitis (PBC) patients in the decompensated stage face poor prognoses, with recompensation being crucial for improving long-term outcomes.
This study aims to evaluate the predictive value of the lymphocyte-to-monocyte ratio (LMR) for recompensation in decompensated PBC patients.
We retrospectively analysed 410 patients with PBC-related decompensated cirrhosis receiving ursodeoxycholic acid (UDCA) treatment. The association between the LMR and recompensation was examined using Cox regression analysis, with additional trend analysis performed based on LMR quartiles. The predictive accuracy of the LMR, neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII) and platelet-to-lymphocyte ratio (PLR) was evaluated using receiver operating characteristic (ROC) curve analysis. Sensitivity analyses were conducted to confirm the robustness of the findings.
During follow-up, among 401 patients with decompensated cirrhosis (age: 60.0 [IQR: 53.0-69.0] years; 88.3% female), 105 patients (26.18%) achieved recompensation. Multivariate Cox regression analysis showed that higher LMR was an independent promoting factor for recompensation after adjusting for all confounding factors in the model (HR = 1.415, 95% CI: 1.264-1.585, p < 0.001), with a linear positive correlation trend. ROC curve analysis demonstrated that LMR had superior predictive performance compared to other inflammatory markers (SII, PLR, NLR), with an area under the curve (AUC) of 0.787 (95% CI: 0.736-0.838, p < 0.001).
LMR serves as a robust independent predictor for recompensation in decompensated PBC patients.
失代偿期原发性胆汁性胆管炎（PBC）患者预后较差，实现病情代偿对改善长期预后至关重要。
本研究旨在评估淋巴细胞与单核细胞比值（LMR）对失代偿期PBC患者病情代偿的预测价值。
我们回顾性分析了410例接受熊去氧胆酸（UDCA）治疗的PBC相关性失代偿期肝硬化患者。采用Cox回归分析检验LMR与病情代偿之间的关联，并基于LMR四分位数进行额外的趋势分析。使用受试者工作特征（ROC）曲线分析评估LMR、中性粒细胞与淋巴细胞比值（NLR）、全身免疫炎症指数（SII）和血小板与淋巴细胞比值（PLR）的预测准确性。进行敏感性分析以确认研究结果的稳健性。
在随访期间，401例失代偿期肝硬化患者（年龄：60.0[四分位间距：53.0 - 69.0]岁；88.3%为女性）中，105例（26.18%）实现了病情代偿。多因素Cox回归分析显示，在对模型中的所有混杂因素进行调整后，较高的LMR是病情代偿的独立促进因素（HR = 1.415，95%CI：1.264 - 1.585，p < 0.001），呈线性正相关趋势。ROC曲线分析表明，LMR与其他炎症标志物（SII、PLR、NLR）相比具有更好的预测性能，曲线下面积（AUC）为0.787（95%CI：0.736 - 0.838，p < 0.001）。
LMR是失代偿期PBC患者病情代偿的可靠独立预测指标。
Zotero 插件
