乙型肝炎肝硬化患者外周血dNLR、MLR和SII变化及其临床意义分析

Changes of peripheral blood dNLR, MLR and SII in patients with hepatitis B cirrhosis

目的探讨乙型肝炎肝硬化患者外周血衍生中性粒细胞/淋巴细胞比值(dNLR)、单核细胞/淋巴细胞比值(MLR)和系统性免疫性炎症指数(SII)变化及其临床意义.方法2019年1月~2021年12月我院收治的乙型肝炎肝硬化患者85例和慢性乙型肝炎(CHB)患者85例,采用ELISA法检测血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和IL-17.常规检测血细胞计数.结果乙型肝炎肝硬化患者血清TBIL和INR分别为(43.1±8.5)μmol/L和(1.3±0.6),显著高于[分别为(19.4±3.0)μmol/L和(1.1±0.2),P<0.05],而血清ALT和ALB水平分别为(63.6±8.2)U/L和(30.8±4.6)g/L,显著低于CHB组[分别为(104.1±14.9)U/L和(39.0±8.1)g/L,P<0.05];肝硬化患者血清TNF-α、IL-6和IL-17水平分别为(88.7±11.6)pg/mL、(95.6±12.5)pg/mL和(45.6±8.9)ng/mL,显著高于CHB组[分别为(68.2±9.3)pg/mL、(67.9±9.5)pg/mL和(25.5±5.1)ng/mL,P<0.05];肝硬化患者外周血dNLR、MLR和SII分别为(2.2±0.5)、0.8(0.7,0.9)和(553.9±83.4),显著高于CHB组[分别为(1.8±0.3)、0.6(0.5,0.7)和(481.4±99.3),P<0.05];Child B/C级乙型肝炎肝硬化患者外周血dNLR、MLR和SII显著高于A级乙型肝炎肝硬化患者(P<0.05),Child C级乙型肝炎肝硬化患者外周血dNLR、MLR和SⅡ显著高于B级乙型肝炎肝硬化患者(P<0.05).结论乙型肝炎肝硬化患者外周血dNLR、MLR和SII显著升高,且它们的变化与病情严重程度有关.

Objective The aim of this study was to explore the clinical implication of peripheral blood derived neutrophil to lymphocyte ratio(dNLR),monocyte to lymphocyte ratio(MLR)and systemic immune inflammatory index(SII)in patients with hepatitis B liver cirrhosis(LC).Methods 85 patients with hepatitis B-induced LC and 85 patients with chronic hepatitis B(CHB)were encountered in our hospital between January 2019 and December 2021.Serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and IL-17 levels were detected by ELISA.The peripheral blood platelet,lymphocyte,neutrophil and monocyte counts were detected by full-automatic blood cell analyzer.Results Serum bilirubin level and INR in patients with LC were(43.1±8.5)μmol/L and(1.3±0.6),much higher than[(19.4±3.0)μmol/L and(1.1±0.2),P<0.05],while serum ALT and albumin levels were(63.6±8.2)U/L and(30.8±4.6)g/L,much lower than[(104.1±14.9)U/L and(39.0±8.1)g/L,respectively,P<0.05]in patients with CHB;serum TNF-α,IL-6 and IL-17 levels in patients with LC were(88.7±11.6)pg/mL,(95.6±12.5)pg/mL and(45.6±8.9)ng/mL,significantly higher than[(68.2±9.3)pg/mL,(67.9±9.5)pg/mL and(25.5±5.1)ng/mL,respectively,P<0.05]in patients with CHB;the dNLR,MLR and SII in patients with(2.2±0.5),0.8(0.7,0.9)and(553.9±83.4),significantly higher than[(1.8±0.3),0.6(0.5,0.7)and(481.4±99.3),P<0.05]in patients with CHB;the dNLR,MLR and SII in LC patients with Child class B/C were significantly higher than in those with Child class A(P<0.05),and the dNLR,MLR and SII in patients with Child class C were significantly higher than in patients with Child class B(P<0.05).Conclusion The peripheral blood dNLR,MLR and SII significantly increase in patients with hepatitis B cirrhosis,and their changes are related to disease severity.