摘要
目的探讨瞬时弹性成像技术联合中性粒细胞淋巴细胞比值(NLR)、血小板淋巴细胞比值(PLR)预测乙型肝炎肝硬化并发症的应用价值,并研究以上各个指标与乙型肝炎肝硬化严重程度的关系。方法回顾性分析2018年1月至2020年9月就诊于滨州医学院烟台附属医院并诊断为乙型肝炎肝硬化患者76例,根据Child-Pugh(CPT)评分,将其分为CPT A级、B级、C级;同时根据终末期肝病模型(MELD)评分分为≤9分组及≥10分组;对76例乙型肝炎肝硬化患者,根据有无并发症,分为并发症组和无并发症组,并根据并发症的数量将并发症组分为单一并发症组和多个并发症组,对比分析NLR、PLR、肝脏硬度值(LSM)在各组间的变化,进一步分析各个指标与CPT评分及MELD评分是否具有相关性,并评估其相关性强度和意义。最后利用ROC曲线分别分析各指标及联合应用对乙型肝炎肝硬化并发症是否有预测价值。结果NLR、LSM与CPT评分及MELD评分均呈正相关,PLR与CPT评分及MELD评分均呈负相关。并发症组的NLR、LSM高于无并发症组,PLR低于无并发症组。单一并发症组的NLR、LSM低于多个并发症组,PLR高于多个并发症组。NLR、PLR、LSM、NLR联合PLR、NLR联合LSM、PLR联合LSM、三者联合对乙型肝炎肝硬化并发症的预测价值应用AUC表示,分别为0.715、0.691、0.777、0.770、0.811、0.830、0.839;其中NLR、PLR、LSM对应的最佳界值分别为2.101、76.92、19.3。结论1.NLR、PLR、LSM均与乙型肝炎肝硬化病情严重程度有关,可用于评估肝硬化病情严重程度。2.NLR、LSM与肝硬化病情严重程度呈正相关,PLR呈负相关。3.NLR、PLR、LSM、两两联合及三者联合对于肝硬化并发症均有一定预测价值,其中NLR、PLR、LSM三者联合对于肝硬化并发症预测价值最佳。
Objective To explore the application value of transient elastography combined with neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)in predicting the complications of hepatitis B cirrhosis,and to study the relationship between the above indicators and the severity of hepatitis B liver cirrhosis.Methods Retrospective analysis was conducted on 76 patients with hepatitis B liver cirrhosis who were diagnosed in the Binzhou Medical University Hospital from January 2018 to September 2020,and it is divided into CPT A,CPT B,CPT C according to the Child-Pugh(CPT)score;at the same time,it is divided into≤9 group and≥10 group according to MELD score;according to the presence or absence of complications,76 patients with hepatitis B liver cirrhosis were divided into the complication group and the non-complication group;and according to the number of complications,the complication group was divided into the single complication group and the multiple complication group.The changes of NLR,PLR and liver hardness value(LSM)among the groups were compared and analyzed,and the correlation between each index and CPT score and MELD score was further analyzed,and the strength and significance of the correlation were evaluated.Finally,the ROC curve was used to analyze whether each index and the combined application had predictive value for the complications of hepatitis B liver cirrhosis.Results NLR and LSM were positively correlated with CPT score and MELD score,and PLR was negatively correlated with CPT score and MELD score.The NLR and LSM of the complication group were higher than those of the non-complication group,and the PLR was lower than that of the non-complication group.The NLR and LSM of the single complication group were lower than those of the multiple complication group,and the PLR was higher than that of the multiple complication group.The predictive value of NLR,PLR,LSM,NLR combined with PLR,NLR combined with LSM,PLR combined with LSM were expressed by AUC as 0.715,0.691,0.777,0.770,0.811,0.830,and 0.839,respectively,where the best cut-off values for NLR,PLR,and LSM were 2.101,76.92,and 19.3 respectively.Conclusion 1.NLR,PLR,LSM are all related to the severity of hepatitis B liver cirrhosis,and can be used to assess the severity of liver cirrhosis.2.NLR and LSM are positively correlated and PLR is negatively correlated with the severity of liver cirrhosis.3.NLR,PLR,LSM,the combination of two and the combination of the three have certain predictive value for the complications of liver cirrhosis,and the combination of NLR,PLR and LSM has the best predictive value for the complications of liver cirrhosis.
作者
贺燕燕
刘一品
HE Yanyan;LIU Yipin(Yantai Affiliated Hospital of Binzhou Medical University,Yantai 264100,Shandong,P.R.China)
出处
《滨州医学院学报》
2021年第3期167-172,共6页
Journal of Binzhou Medical University
