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Plos One:嗜中性粒细胞-淋巴细胞比例可以预测乙肝相关急性肝衰竭患者的短期死亡率

2017-04-22 MedSci MedSci原创

乙型肝炎病毒相关的急性肝衰竭具有很高的短期死亡率。人工肝支持系统(ALSS)可以改善患者的结局并避免肝移植。但是,预测此类患者的短期预后仍然是困难的。近期,一项发表在杂志Plos One上的研究旨在确定中性粒细胞-淋巴细胞比例(NLR),一种炎症标志物,是否能够预测ALSS患者的死亡率。此项研究共纳入560例乙型肝炎病毒相关慢性肝衰竭急性发作的患者,其中338例接受ALSS治疗,其余接受标准护理治

乙型肝炎病毒相关的急性肝衰竭具有很高的短期死亡率。人工肝支持系统(ALSS)可以改善患者的结局并避免肝移植。但是,预测此类患者的短期预后仍然是困难的。


近期,一项发表在杂志Plos One上的研究旨在确定中性粒细胞-淋巴细胞比例(NLR),一种炎症标志物,是否能够预测ALSS患者的死亡率。

此项研究共纳入560例乙型肝炎病毒相关慢性肝衰竭急性发作的患者,其中338例接受ALSS治疗,其余接受标准护理治疗(SOC)。评估临床变量和NLR的预后价值。

此项研究结果显示:ALSS的30天死亡率为28.4%,SOC患者为30.4%。ALSS或SOC患者中存活者的NLR低于死亡的患者。单变量和多变量分析发现,NLR和慢性肝衰竭序贯器官衰竭评估评分(CLIF-SOFA)与30天死亡率独立相关。

在NLR≤3,3-6和≥6的患者中,ALSS治疗组的30天死亡率分别为7.7%,23.1%和69.2%,SOC治疗组为25.5%,50.0%,75.0%。

在NLR≤3或3-6的患者中,ALSS患者的死亡率低于SOC患者(P <0.01)。

在NLSS> 6的ALSS和SOC治疗组的死亡率无差异(P> 0.05)。NLR和CLIF-SOFA曲线下的面积在ALSS组为0.82和0.88,SOC组为0.78和0.86。

此外,此项研究还显示,大多数NLRs≤3的患者经过ALSS治疗可以恢复肝功能,而NLR> 6的患者需要进行急性肝移植。

此项研究结果表明,NLR是ALSS患者死亡率的独立预测因子,可协助医生确定治疗方案。

原始出处:
Fan Z, EnQiang C, et al. Neutrophil-lymphocyte ratio predicts short term mortality in patients with hepatitis B virus-related acute-on-chronic liver failure treated with an artificial liver support system. PLoS One. 2017 Apr 20;12(4):e0175332. doi: 10.1371/journal.pone.0175332. eCollection 2017.

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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302055, encodeId=822a130205580, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Mon Apr 24 05:31:00 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=189834, encodeId=2de218983456, content=很有启发性, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aadd1680584, createdName=蔬菜, createdTime=Sun Apr 23 08:36:16 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=189769, encodeId=927b189e69ab, content=学习了,继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sun Apr 23 02:54:02 CST 2017, time=2017-04-23, status=1, ipAttribution=)]
    2017-04-24 周周人

    学习了,谢了。

    0

  6. 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  8. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1302055, encodeId=822a130205580, content=<a href='/topic/show?id=82a6659902c' target=_blank style='color:#2F92EE;'>#淋巴细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65990, encryptionId=82a6659902c, topicName=淋巴细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Mon Apr 24 05:31:00 CST 2017, time=2017-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=189834, encodeId=2de218983456, content=很有启发性, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aadd1680584, createdName=蔬菜, createdTime=Sun Apr 23 08:36:16 CST 2017, time=2017-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=189769, encodeId=927b189e69ab, content=学习了,继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sun Apr 23 02:54:02 CST 2017, time=2017-04-23, status=1, ipAttribution=)]
    2017-04-23 蔬菜

    很有启发性

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=189769, encodeId=927b189e69ab, content=学习了,继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sun Apr 23 02:54:02 CST 2017, time=2017-04-23, status=1, ipAttribution=)]
    2017-04-23 半夏微凉

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