论著
目的 分析单核细胞-淋巴细胞比率(MLR)联合游离三碘甲腺原氨酸(FT3)对乙型肝炎病毒(HBV)相关慢加急性肝衰竭(ACLF)患者生存状况的预测效果。方法 纳入我院在2019年1月—2022年1月期间收治的HBV-ACLF患者共187例进行研究,随访患者90 d的生存状况,其中69例死亡患者设为死亡组,其余118存活患者设为存活组。对2组患者的各项资料进行单因素分析,对差异有统计学意义的因素行Logistic多因素分析,分析HBV-ACLF患者死亡的危险因素,并分析MLR联合FT3对HBV-ACLF死亡的预测效果。结果 死亡组患者的年龄、肝硬化发生率、原发性腹膜炎发生率、肝肾综合征发生率、电解质紊乱发生率、终末期肝病模型、MLR、中性粒细胞与淋巴细胞计数比值、国际标准化比值、肌酐、白细胞计数、总胆红素水平均高于B组,血钠、FT3、总血清胆固醇水平均低于存活组,差异有统计学意义(P<0.05)。MLR≥0.60、FT3≤2.50 pmol/L均为HBV-ACLF患者死亡的危险因素(P<0.05)。MLR、FT3、MLR+FT3对HBV-ACLF患者死亡均有一定的预测价值,但MLR+FT3的预测价值高于其他单项预测。结论 MLR≥0.60、FT3≤2.50 pmol/L均为HBV-ACLF患者死亡的危险因素(P<0.05),且二者联合应用对HBV-ACLF患者死亡有较佳的预测价值。
Objective To analyze the predictive effect of mononuclear-lymphocyte ratio(MLR)combined with free triiodothyronine(FT3)on the survival of patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods In the study,187 patients with HBV-ACLF from January 2019 to January 2022 in our hospital were included,and the survival status of the patients was followed up for 90 days.Among them,69 patients were included in the death group and the rest 118 patients were included in the survival group.The data of the two groups of patients were analyzed by univariate analysis,and the statistically significant factors were analyzed by Logistic multifactor analysis.The risk factors of death in patients with HBV-ACLF were analyzed,and the predictive effect of MLR combined with FT3 on the death of HBV-ACLF was analyzed.Results The age,incidence of cirrhosis,primary peritonitis,hepatorenal syndrome,electrolyte disturbance,ratio of neutrophil to lymphocyte count,international standardized ratio,model for end stage liver disease,MLR,creatinine,white blood cell count and total bilirubin of the patients in the death group were higher than those in survival group,and the levels of serum sodium,FT3 and total cholesterol were lower than those in survival group,the differences were significant(P<0.05).The results showed that MLR≥0.60,FT3≤2.50 pmol/L were risk factors for death of HBV-ACLF patients(P<0.05).MLR,FT3,MLR+FT3 had certain predictive value for the death of HBV-ACLF patients,but the predictive value of MLR+FT3 was higher than other single prediction.Conclusions MLR≥0.60 and FT3≤2.50 pmol/L are risk factors for death of patients with HBV-ACLF(P<0.05),and the combination of the two has a better predictive value for death of patients with HBV-ACLF.
论著
目的 探讨接受冠状动脉造影患者的中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)和单核细胞-淋巴细胞比值(MLR)与冠状动脉疾病(CAD)严重程度的关系。方法 收集2021年1月—2021年12月在六安市人民医院接受冠状动脉造影的150例急性冠脉综合征(ACS)患者。CAD的严重程度通过Gensini评分进行评估,150例ACS患者根据评分被分为轻度病变组(≤14分,41例)、中度病变组(15~47分,69例)和重度病变组(≥48分,40例)。比较3组的临床指标,采用相关统计学分析NLR、PLR、MLR与CAD严重性(Gensini评分)的相关性。结果 纳入研究的150例患者的平均年龄为(66.49±11.43)岁,男性占67.3%。在重度病变组,NLR和PLR值高于其他两组。在Pearson相关性检验中,Gensini评分与NLR呈正相关(r=0.319,P<0.001),然而,Gensini评分与MLR、PLR之间无相关性(P>0.05)。在Logistic回归分析中,NLR(OR:1.306,95%CI:0.107~0.427)是CAD的独立危险因素。在ROC曲线分析中,发现NLR的曲线下面积最高,为0.723(95%CI:0.629~0.817,P<0.001),NLR≥0.25为识别CAD存在的最佳临界值,灵敏度为78.49%,特异度为60.26%。结论 根据Gensini评分,NLR与CAD的严重程度呈正相关,而研究中未观察到MLR、PLR与CAD严重程度之间的关联。
Objective To explore the correlation of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio(MLR)with coronary artery disease(CAD)severity in patients undergoing coronary angiography.Methods A total of 150 patients with acute coronary syndrome(ACS)who underwent coronary angiography in Lu'an People's Hospital from January 2021 to December 2021 were enrolled.The severity of CAD was assessed by Gensini score,according to the score,150 patients with ACS were divided into mild disease group(≤14 points,41 cases),moderate disease group(15-47 points,69 cases)and severe disease group(≥48 points,40 cases).Clinical indicators of the three groups were compared,and related statistics were used to analyze the correlation between NLR,PLR,MLR and the severity of coronary artery lesions(Gensini score).Results The average age of selected 150 patients was(66.49±11.43),67.3% were male.In the severe disease group,NLR,PLR values were higher than the other two groups.A positive significant correlation was found between Gensini score and NLR(r=0.319,P<0.001)by Pearson's correlation test.However,no correlation was found between Gensini score and MLR and PLR(P>0.05).In the Logistic regression analysis,NLR(OR:1.306,95% CI:0.107-0.427)was the independent risk factor of CAD.In receiver operating characteristic curve analysis,NLR was found to have highest area under the curve at 0.723(95% CI:0.629-0.817,P<0.001),with an optimal cut-off value of 0.25,predicting the severe coronary lesion with a sensitivity of 60.26% and specificity of 78.49%.Conclusions The NLR is positively correlated with the severity of CAD.No correlation between MLR,PLR and severity of CAD in the cohort were observed.