MLR联合MELD评分对乙型肝炎相关慢加急性肝衰竭预后的预测价值

Predictive effect of monocyte lymphocyte ratio combined with MELD score on prognosis of hepatitis B virus-related acute-on-chronic liver failure

目的:分析单核细胞-淋巴细胞比率(MLR)联合终末期肝病模型(MELD)评分对乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)预后的预测价值。方法:选取2019年1月至2022年1月我院收治的167例HBV-ACLF患者为研究对象,随访患者90 d的生存状况,肝移植或死亡患者纳入预后不良组(n=80),其余患者纳入预后良好组(n=87)。采用logistic回归分析HBV-ACLF患者预后的影响因素,并绘制ROC曲线,分析MLR联合MELD评分对HBV-ACLF预后的预测价值。结果:MLR、MELD评分是HBV-ACLF患者预后的影响因素(P<0.05);MLR、MELD评分、MLR联合MELD评分预测患者预后的AUC分别为0.640、0.679、0.792。结论:MLR升高及MELD评分高与HBV-ACLF患者预后不良有关,MLR联合MELD评分对HBV-ACLF患者预后的预测价值较高。

Objective:To analyze the predictive value of monocyte lymphocyte ratio(MLR) combined with MELD score on the prognosis of hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods:A total of 167 HBV-ACLF patients in our hospital from January 2019 to January 2022 were enrolled in the study.The survival status of the patients was followed up for 90 days.Patients who underwent liver transplantation or died were included in a poor prognosis group(n=80),while other patients were included in a good prognosis group(n=87).Logistic regression analysis was used to analyze the influencing factors of prognosis in HBV-ACLF patients,and ROC curve was drawn to analyze the predictive value of MLR combined with MELD score on the prognosis of HBV-ACLF.Results:MLR and MELD scores were influencing factors of prognosis in HBV-ACLF patients(P<0.05).The AUC of MLR,MELD score,and MLR combined with MELD score for predicting the prognosis of the patients were 0.640,0.679 and 0.792,respectively.Conclusion:Elevated MLR and high MELD scores are associated with poor prognosis in HBV-ACLF patients.The combination of MLR and MELD scores has a higher predictive value for the prognosis of HBV-ACLF patients.