血小板/淋巴细胞比值和中性粒细胞/淋巴细胞比值与肝衰竭预后相关性研究

Correlation of platelet-lymphocyte ratio and neutrophil-lymphocyte ratio with prognosis of liver failure

目的探究外周血中血小板/淋巴细胞比值(platelet-lymphocyte ratio,PLR)和中性粒细胞/淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)在嗜肝病毒导致的肝衰竭疾病进展及预后中的临床意义。方法回顾性分析徐州医科大学附属医院电子病历系统数据,纳入2016年1月至2017年12月于我院感染性疾病&肝病科住院的嗜肝病毒感染导致的肝衰竭患者共168例,进行PLR、NLR与预后相关性研究。结果 NLR、PLR在肝衰竭预后中均有预测价值,NLR预测价值优于PLR。入院时合并感染、乙肝病毒感染、戊肝病毒感染、治疗过程中并发感染患者所占比例及中性粒细胞(N)、NLR、INR、TBiL在未好转组均明显高于好转组,差异有统计学意义(P<0.05)。淋巴细胞(L)、PTA、ALB好转组均明显高于未好转组,差异有统计学意义(P<0.05)。各种临床类型患者所占比例差异有统计学意义(P<0.05)。结论 PLR和NLR预测在嗜肝病毒导致的肝衰竭预后中有一定的指示作用,且NLR预测效果优于PLR。

Objective To investigate the clinical significance of platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) in peripheral blood in the progression and prognosis of liver failure caused by hepatotropic virus . Methods Data from the electronic medical record system of Xuzhou Medical University Affiliated Hospital were retrospectively analyzed. According to the inclusion and exclusion criterias, patients with liver failure caused by hepatotropic virus infection admitted to Department of the Infectious Diseases and Liver Diseases of our hospital from Jan. 2016 to Dec. 2017 were included. A total of 168 patients meeting the inclusion criterias were selected for the correlation study between PLR, NLR and prognosis. Results NLR and PLR had predictive value in the prognosis of liver failure,and NLR predictive value was superior to PLR. Concomitant infection, hepatitis B virus infection, hepatitis E virus infection at admission, proportion of concurrent infection during treatment, and neutrophile, NLR, INR and TBiL in the unimproved group were significantly higher than those in the improved group, with statistically significant differences. The lymphocyte, PTA and ALB of improvement group were significantly higher than those of non-improvement group, and the difference was statistically significant. The proportion of patients with various clinical types was statistically different between the groups. Conclusion PLR and NLR have a certain role in the progression and prognosis of viral liver disease, and NLR is closely related to disease progression.