广州医药 ›› 2025, Vol. 56 ›› Issue (3): 387-392.DOI: 10.20223/j.cnki.1000-8535.2025.03.016

• 论著 • 上一篇    下一篇

ALBI联合NLR预测肝硬化合并食管胃底静脉曲张破裂出血的作用

何艳婷, 苏有盛, 叶宇龙   

  1. 肇庆市第一人民医院消化内科(广东肇庆 526060)
  • 收稿日期:2024-04-09 出版日期:2025-03-20 发布日期:2025-04-08

The role of ALBI combined with NLR in predicting liver cirrhosis complicated with esophageal and gastric varices bleeding

HE Yanting, SU Yousheng, YE Yulong   

  1. Department of Gastroenterology,the First People's Hospital of Zhaoqing City,Zhaoqing 526060,China
  • Received:2024-04-09 Online:2025-03-20 Published:2025-04-08

摘要: 目的 探讨白蛋白-胆红素(ALBI)联合中性粒细胞与淋巴细胞比值(NLR)预测肝硬化合并食管胃底静脉曲张破裂出血(EGVB)的临床价值。方法 回顾性分析2021年1月—2022年12月肇庆市第一人民医院消化内科收治的80例肝硬化合并EGVB患者的临床资料,通过电话及门诊、再入院对其进行为期1年的随访,根据随访结果,将其分为2组,即存活组(n=69)与死亡组(n=11),分析导致患者死亡的危险因素,并评估ALBI联合NLR预测肝硬化合并EGVB患者死亡的临床价值。结果 死亡组的年龄60岁以上、腹水和肝性脑病者占比,总胆红素(TBiL)、NLR、凝血酶原时间(PT)、谷丙转氨酶(ALT)水平及ALBI评分均高于存活组(均P<0.05),而血红蛋白(HGB)、白蛋白(ALB)及血钠水平均低于存活组(均P<0.05);Logtisic回归分析显示,年龄60岁以上、腹水、肝性脑病和TBiL、NLR水平升高及ALBI分级为3级是肝硬化合并EGVB患者死亡的危险因素(均P<0.05);ALBI联合NLR预测肝硬化合并EGVB患者预后的准确率及灵敏度高于单一诊断,漏诊率低于单一诊断(P<0.05)。结论 肝硬化合并EGVB患者可见ALBI评分及NLR水平升高,而以上两种指标是患者死亡的危险因素,将其联合检测可评估患者预后,预测其死亡风险。

关键词: 白蛋白-胆红素, 中性粒细胞淋巴细胞比值, 肝硬化, 食管胃底静脉曲张破裂出血

Abstract: Objective To investigate the clinical value of albumin-bilirubin(ALBI)combined with neutrophil lymphocyte ratio(NLR)in predicting liver cirrhosis complicated with esophageal and gastric varices bleeding(EGVB).Methods The clinical data of 80 patients with liver cirrhosis complicated with EGVB admitted to the Department of Gastroenterology of the First People's Hospital of Zhaoqing from January 2021 to December 2022 were retrospectively analyzed.They were followed up for one year by telephone,outpatient service and readmission.According to the follow-up results,they were divided into the survival group(n=69)and the death group(n=11).The risk factors leading to the death of patients were analyzed and evaluated.Results The proportion of age over 60,ascites and hepatic encephalopathy,the levels of TBiL,NLR,PT,ALT and ALBI in the death group were higher(P<0.05),while the levels of HGB,ALB and blood sodium were lower(P<0.05).Logistics analysis showed that age over 60,ascites,hepatic encephalopathy,NLR and ALBI grade 3 were independent risk factors for the death(P<0.05).The accuracy and sensitivity of ALBI combined with NLR in predicting their prognosis were significantly higher than that of single diagnosis,and the missed diagnosis rate was lower(P<0.05).Conclusions ALBI scores and NLR levels significantly increase in patients with liver cirrhosis complicated with EGVB,and the above two indexes are risk factors for the death,and the combination of them can evaluate the prognosis of patients and predict the death risk.

Key words: albumin-bilirubin, neutrophil lymphocyte ratio, cirrhosis, bleeding from esophageal and gastric varices rupture