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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

23卷

期数:

2017年02期

页码:

151-154

栏目:

临床医学

出版日期:

2017-03-20

文章信息/Info

Title:

Short-term prognostic value of pre-operative NLR, serum procalcitonin and MELD model in patients with aute-on-chronic(subacute) liver failure

文章编号:

1006-8147（2017）02-0151-04

作者:

陈岭岭¹; 李 谦²

（1．天津医科大学研究生院，天津300070；2，天津市第二人民医院重症监护室，天津300092）

Author(s):

CHEN Ling-ling¹;  LI Qian²

（1．Graduate School ，Tianjin Medical University，Tianjin 300070, China; 2. ICU ， The Second People’s Hospital of

Tianjin, Tianjin 300092, China）

关键词:

中性粒细胞/淋巴细胞;  血清降钙素原; MELD评分; 慢加急（亚急）性肝衰竭

Keywords:

neutrophils/lymphocytes ;  procalcitonin;  MELD model;  aute-on-chronic(subacute) liver failure

分类号:

R575.3

DOI:

-

文献标志码:

A

摘要:

目的： 探讨外周血中性粒细胞与淋巴细胞比值（NLR）、血清降钙素原（PCT）及MELD评分系统对慢加急（亚急）性肝衰竭近期预后（3月）的预测价值。方法： 收集68名慢加急（亚急）性肝衰竭患者，根据患者预后状况分为生存组与死亡组，并根据入院后是否并发细菌感染分为感染组及非感染组，记录患者入院时的常规肝脏生化指标、凝血4项、血常规、PCT，以正常体检者33例为对照组，记录体检者查体时的血常规、PCT，分别计算MELD、NLR。结果：肝衰竭组入院时的NLR、PCT明显高于对照组，死亡组入院时NLR、PCT、MELD值高于生存组，感染组NLR、PCT、MELD值高于非感染组，均有统计学意义（P<0.05）；感染组与非感染组死亡率分别为65.0% 和35.71%；通过绘制ROC曲线，肝衰竭组入院时NLR、PCT、MELD评分的ROC曲线下面积分别为0.747、0.573、0.694； Logistic分析入院时的NLR与MELD评分是影响肝衰竭近期生存的独立危险因素。结论：入院时外周血NLR、PCT及MELD评分对慢加急（亚急）性肝衰竭有预测价值；入院时NLR、MELD评分是影响肝衰竭生存的独立危险因素。

Abstract:

Objective：To explore the short-term (3 months) prognostic value of pre-operative the rate of the Neutrophils and Lymphocytes（NLR）, serum procalcitonin（PCT） and MELD model in patients with aute-on-chronic(subacute) liver failure. Methods: A total of 68 patients with aute on-chronic(subacute) liver failure were divided into survival group and dead group, with or without infection group. The hepatic biological indices, blood routine, PCT, and blood coagulation were recorded in patients with liver failures. Thirty-three normal health examinations were collected as control group . Results： The NLR, PCT were increased both in patients with liver failure and in infection group significantly (P<0.05). The mortality of the infection and non-infection group was 65.0% and 35.71%. The NLR was increased in dead group significantly, but the PCT was not. The AUC of NLR,PCT and MELD was 0.747,0.573,0.694,by the logistic regression model analysis, the NLR and MELD score were positively associated with the outcome. Conclusion： The NLR,PCT are increased both in patients with liver failure and in infection group significantly. The NLR、MELD score on admission could be independent risk factors for hepatic failure survival.