中性粒细胞与淋巴细胞比值评估急性/亚急性肝衰竭预后的价值

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DOI：10.16424/j.cnki.cn32-1807/r.2025.04.012

[关键词]急性/亚急性肝功能衰竭;中性粒细胞与淋巴细胞比值；预后 [中图分类号]R575.3 [文献标志码]A [文章编号] 1674-7887（2025）04-0370-05

Evaluating the prognostic value of neutrophil-to-lymphocyte ratio inacute/subacute liver failure

WANGXiaoyan1*，ZHANGYuyel，BIAN Zhaolian2，TIANLijun3，HANXudong*** （'Medical School，Nantong University， Jiangsu226Ool;DepartmentofGastroenterologytensiveCareUnit，AffliatedNantongHospital3ofNantongUivsity [Abstract]Objective：Toexploretheprognosticvalueoftheneutrophiltolymphocyteratio（NLR）inpatientswithacute/subacuteliverfailure（ALF/SALF）.Methods：ClinicaldataofALF/SALFpatients treatedatAfliatedNantongHospital3ofNantong UniversityfromMarchO15toSeptemberO23wereretrospectivelyanalyzed，incudingage，sex，etiologylaboratoryrsults （post-admission），NLR，model forend-stage liverdisease（MELD）score，MELD-Nascore，andiMELD score.Basedonpatient transplant-fre survivalstatusat28daysoffolow-up，theywevedividedintothesurvivalgroupandthemortalitygroup.Logistic regresionwasemployedtoinvestigatecontributingfactorsinfluencing theprognosisofALF/SALFpatients.ROCcurvesevaluated the predictivevalueofNLR，ge，ntermationalnormalizedratio（INR），andtheircombinationfortheprognosisofALF/ALF prognosis.SurvivalcurvesdeterminedtheoptimalNLRcutoffvaueforprognosticstratification.Results：113enrolldpatients werestratified into survival group（ n =56）and mortality group（n=57）.The mortality group exhibited significantly higherage，INR， neutrophil count，neutrophil percentage，NLR，andiMELDscore，alongsideloweralbumin，lymphocytecount，lymphocte percentage，monocyte percentage，and platelet count versus the survival group（all P<0.05 5）.NLR positively correlated with iMELD score（r=0.199， P =0.035）. Elevated NLR served as an independent risk factor for poor prognosis in ALF/SALF patients. The combination of NLR，age，and INR demonstrated superior prognostic predictive power（AUC=0.80，95%CI： 0.7-0.89） comparedwithanysingle parameter.TheoptimalNLRcut-off was6.55.Patients withNLR≥6.55had significantlylower 28- day survival than those with NLR<6.55（23.26% vs 65.71% χ2 =19.21， P<0.000 1）. Conclusion： NLR serves as an effective prognosticbiomarkerinALF/SALFandisanindependentriskfactorformortality.ElevatedNLRcorelateswithpoorerprognosis. Combining NLR with age and INR enhances prognostic assessment accuracy in ALF/SALF patients. [Key Words]acute/subacute liver failure; neutrophil to lymphocyte ratio;prognosis

肝衰竭是临床常见的严重肝病症候群，病死率极高。（剩余8210字）