摘要
目的探究亚太肝脏研究协会ACLF(AARC-ACLF)评分联合中性粒细胞与淋巴细胞比值(NLR)对HBV相关慢加急性肝衰竭(ACLF)短期预后的预测价值。方法选择94例HBV相关ACLF患者作为研究对象,于入组24 h内检测NLR,计算AARC-ACLF评分。根据临床疗效及生存情况,分为转归良好组及不佳组。分析HBV相关ACLF患者病情转归的影响因素。评估AARC-ACLF评分和血清NLR水平对HBV相关ACLF预后的预测效能。结果94例受试者中,转归良好58例,转归不佳36例。转归不佳组凝血酶原时间(PT)、总胆红素(TBil)、白细胞(WBC)、NLR及AARC-ACLF评分分别为(26.68±6.91)s、(330.2±126.4)μmol/L、(6.67±2.06)×10^(9)/L、6.45±2.76、(10.14±1.29)分,转归良好组为(20.32±4.20)s、(180.1±83.7)μmol/L、(5.06±1.97)×10^(9)/L、2.85±1.67、(8.03±1.09)分,差异有统计学意义(P<0.05)。NLR及AARC-ACLF评分偏高均为HBV相关ACLF患者病情转归不佳的影响因素(P<0.05);血清NLR、AARC-ACLF评分、NLR联合AARC-ACLF评分预测HBV相关ACLF患者预后的AUC分别为0.878、0.892、0.943。结论HBV相关ACLF患者的血清NLR及AARC-ACLF评分均较高,对该病的短期预后具有一定的临床预测价值,且两者联合预测效能更高。
Objective To investigate the predictive value of the ACLF Research Group(AARC-ACLF)score combined with the neutrophil-to-lymphocyte ratio(NLR)in assessing the short-term prognosis of hepatitis B(HBV)-related chronic acute liver failure(ACLF).Methods A total of 94 patients diagnosed with HBV-related ACLF were included in this study.Upon admission,the NLR was assessed,and the AARC-ACLF score was calculated within 24 hours.Based on clinical efficacy and survival outcomes,patients were divided into a favorable prognosis group and an unfavorable prognosis group for further analysis of factors influencing disease progression in HBV-related ACLF.The predictive capacity of the AARC-ACLF score and serum NLR level on the prognosis of HBV-related ACLF was assessed.Results Among the 94 participants,58 showed a favorable prognosis,while 36 exhibited an unfavorable prognosis.In the unfavorable prognosis group,the prothrombin time(PT),total bilirubin(TBIL),white blood cell count(WBC),NLR,and AARC-ACLF score were significantly higher[(26.68±6.91)s,(330.2±126.4)μmol/L,(6.67±2.06)×10^(9)/L,(6.45±2.76),and(10.14±1.29)points,respectively]compared to those in the favorable prognosis group[(20.32±4.20)s,(180.1±83.7)μmol/L,(5.06±1.97)×10^(9)/L,(2.85±1.67),and(8.03±1.09)points;P<0.05].Elevated NLR and AARC-ACLF scores were identified as significant indicators of poor prognosis among HBV-related ACLF patients(P<0.05).The AUC values for predicting prognosis using serum NLR level,AARC-ACLF score,and the combination of NLR with AARC-ACLF score in HBV-related ACLF patients were 0.878,0.892,and 0.943,respectively.Conclusion Higher serum NLR levels and AARC-ACLF scores in HBV-related ACLF patients suggest their potential as valuable clinical predictors for short-term prognosis.Combining both factors can enhance the predictive power significantly.
作者
韩肇丹
许军
李芃芃
赵卫娟
HAN Zhao-dan;XU Jun;LI Peng-peng;ZHAO Wei-juan(Emergency Department of Wuxi Fifth People′s Hospital,Jiangsu 214000,China)
出处
《肝脏》
2024年第5期538-541,共4页
Chinese Hepatology
基金
江苏省自然科学基金青年项目(BK20190601)。
