中性粒细胞淋巴细胞比值及红细胞分布宽度与慢加急性肝衰竭患者短期生存率的关系分析

Analysis of the Relationship between Neutrophil-lymphocyte Ratio and Red Blood Cell Distribution Width and Short-term Survival Rate in Patients with Acute-on-chronic Liver Failure

目的 分析中性粒细胞淋巴细胞比值(neutrophil lymphocyte ratio,NLR)及红细胞分布宽度(red blood cell distribution width,RDW)与慢加急性肝衰竭(acute-on-chronicliverfailure,ACLF)患者短期生存率的关系。方法 回顾性分析龙岩市第二医院2018年7月—2021年7月接收的113例ACLF患者的临床资料,依据患者治疗后3个月的生存情况分为生存组(65例)及死亡组(48例)。分析ACLF患者短期发生死亡的相关因素,并应用Logistic回归法分析患者发生死亡的独立危险因素。结果 两组患者年龄、性别、吸烟史、饮酒史、白细胞、血小板、甲胎蛋白、谷草转氨酶水平比较,差异无统计学意义(P>0.05);死亡组白蛋白水平(29.78±5.06)g/L低于生存组,总胆红素(386.24±91.24)μmol/L、NLR(7.18±1.67)%、RDW(18.07±2.93)%水平高于生存组,差异有统计学意义(t=2.156、3.363、19.635、9.734,P<0.05)。Logistic回归分析结果显示:患者发生短期死亡的独立危险因素为白蛋白、总胆红素、NLR、RDW(P<0.05)。结论 NLR、RDW水平与ACLF患者短期生存率存在密切联系,为患者短期死亡的独立危险因素,可为临床治疗预测患者生命安全情况提供有力依据。

Objective To analyze the relationship between neutrophil-lymphocyte ratio(NLR)and red blood cell distribution width(RDW)and the short-term survival rate of patients with acute-on-chronic liver failure(ACLF).Methods Retrospective analysis of clinical data of 113 patients with ACLF admitted to Longyan Second Hospital from July 2018 to July 2021.According to the survival status of patients 3 months after treatment,they were divided into survival group(65 cases)and death group(48 cases).The related factors of short-term death in ACLF patients were analyzed,and the independent risk factors of death in patients were analyzed by Logistic regression method.Results There was no statistically significant difference in age,sex,smoking history,drinking history,white blood cells,platelets,alpha-fetoprotein,and aspartate aminotransferase levels between the two groups(P>0.05);the albumin level in the death group(29.78±5.06)g/L was lower than that in the survival group,the levels of total bilirubin(386.24±91.24)μmol/L,NLR(7.18±1.67)%,and RDW(18.07±2.93)%were higher than those in the survival group,the difference was statistically significant(t=2.156,3.363,19.635,9.734,P<0.05).Logistic regression analysis showed that the independent risk factors for short-term death were albumin,total bilirubin,NLR,and RDW(P<0.05).Conclusion The levels of NLR and RDW are closely related to the short-term survival rate of patients with ACLF,and they are independent risk factors for short-term death of patients,which can provide a strong basis for clinical treatment to predict the life safety of patients.