BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to deco...BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.展开更多
Objective:To investigate the diagnostic value of the monocyte-to-large-platelet ratio(MLPR),neutrophil-to-lymphocyte ratio(NLR),and red blood cell distribution width(RDW)for pulmonary embolism(PE)in patients with acut...Objective:To investigate the diagnostic value of the monocyte-to-large-platelet ratio(MLPR),neutrophil-to-lymphocyte ratio(NLR),and red blood cell distribution width(RDW)for pulmonary embolism(PE)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 60 elderly AECOPD patients were enrolled and divided into embolus group(12 cases)and thrombus group(48 cases)according to whether they were combined with pulmonary embolism and the MLPR,NLR,and RDW values of the two groups were determined respectively.Results:The patients in the two groups had different degrees of vascular structural and functional abnormalities,and the MLPR,NLR,and RDW in the embolus group were significantly higher than those in the thrombus group(P<0.05);while the differences in NLR and RDW between the two groups were not significant.Conclusion:MLPR,NLR,and RDW can provide an objective basis for assessing PE in elderly AECOPD patients.展开更多
目的研究中性粒细胞/淋巴细胞比值(N L R)、血小板/淋巴细胞比值(P L R)及红细胞分布宽度(RDW),在感染性休克的诊断、动态监测及预后评估中的临床意义。方法选择感染性休克患者155例(其中死亡组76例、治愈组79例),同期以健康体检人群15...目的研究中性粒细胞/淋巴细胞比值(N L R)、血小板/淋巴细胞比值(P L R)及红细胞分布宽度(RDW),在感染性休克的诊断、动态监测及预后评估中的临床意义。方法选择感染性休克患者155例(其中死亡组76例、治愈组79例),同期以健康体检人群155例作为阴性对照组。比较病例组与对照组在降钙素原(procalcitonin,PCT)、WBC、RDW、PLR及NLR之间的差异,分析各指标对感染性休克的诊断效率及其与PCT的相关性。比较死亡组与治愈组之间的差异,分析各指标与患者结局的相关性。结果 PCT、WBC、RDW、PLR、NLR在病例组与对照组比较差异均有统计学意义,NLR以4.68为诊断临界值,诊断灵敏度和特异度分别为96.1%和95.5%。PLR以14.62为诊断临界值,诊断灵敏度和特异度分别为72.3%和66.4%。PCT与NLR、PLR呈正相关(r=0.884,0.599)。感染性休克病例组中死亡率为49.03%,死亡组与治愈组比较PCT、RDW有差异。患者结局与PCT、RDW呈负相关(r=–0.165,–0.449)。不同时间段患者的PCT、WBC、PLR、NLR有差异,且PCT与NLR、PLR在不同时间段有明显相关性。结论 NLR、PLR与PCT呈明显正相关,可用于辅助诊断及动态监测感染性休克患者,RDW与患者结局呈明显负相关,对患者预后评估有一定的临床意义。展开更多
目的:探讨中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)及红细胞分布宽度(red blood cell distribution width,RDW)对前列腺癌(prostate cancer,PCa)患者...目的:探讨中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)及红细胞分布宽度(red blood cell distribution width,RDW)对前列腺癌(prostate cancer,PCa)患者术后复发转移的价值。方法:选取2016年01月至2018年06月我院收治的PCa患者128例,根据其术后是否发生复发转移分为未复发转移组(n=78)和复发转移组(n=50)。采用Sysmex XN-3000全自动血细胞分析仪检测PCa患者NLR、PLR及RDW水平,分析其与临床病理特征的关系。应用受试者工作特征(receiver operating characteristic,ROC)曲线分析NLR、PLR及RDW预测PCa术后复发转移的价值。Pearson相关分析检测NLR、PLR及RDW之间的相关性。结果:复发转移组NLR(3.72±1.56 vs 2.38±1.14)、PLR(190.82±62.83 vs 158.42±43.70)及RDW[(13.85±1.24)%vs(12.74±0.96)%]水平均明显高于未复发转移组(P<0.01)。复发转移患者NLR、PLR及RDW水平与TNM分期、Gleason评分及分化程度相关(P<0.05)。ROC曲线分析显示,NLR、PLR及RDW预测PCa术后复发转移的最佳截值分别为3.06、181.42、13.28%,三项联合预测PCa术后复发转移的AUC(0.857,95%CI:0.795~0.916)最大,其敏感度和特异度为87.3%和82.0%。相关分析显示,复发转移患者NLR与PLR、RDW均呈正相关(r=0.758、r=0.625,P<0.01),PLR与RDW呈正相关(r=0.548,P<0.01)。结论:术前NLR、PLR及RDW水平升高与PCa术后复发转移有关,三项联合检测对预测PCa术后复发转移有一定的价值。展开更多
目的探讨红细胞分布宽度(RDW)、血小板-淋巴细胞比值(PLR)及血小板胶原受体蛋白Ⅵ(GPⅥ)在冠心病中的水平及临床意义。方法选取2017年1—12月在我院治疗的冠心病患者104例,其中不稳定心绞痛37例(UAP组),心肌梗死32例(AMI组)和稳定型心绞...目的探讨红细胞分布宽度(RDW)、血小板-淋巴细胞比值(PLR)及血小板胶原受体蛋白Ⅵ(GPⅥ)在冠心病中的水平及临床意义。方法选取2017年1—12月在我院治疗的冠心病患者104例,其中不稳定心绞痛37例(UAP组),心肌梗死32例(AMI组)和稳定型心绞痛35例(SAP组),同时选取健康自愿者40名作为对照组,检测各组RDW、PLR、GPⅥ等指标水平,同时采用Gensini评分评估各组病情。结果 UAP组和AMI组RDW、PLR、GPⅥ分别为(15.11±1.60)%和(15.03±1.89)%、(140.41±32.24)和(137.55±30.15)、(62.16±14.46) pg/mL和(60.70±15.51) pg/mL,明显高于对照组和SAP组;UAP组和AMI组肌酸激酶同工酶MB(CK-MB)、心肌肌钙蛋白T(cTnT)、心肌肌钙蛋白I(cTnI)分别为(132.44±24.44)IU/L 和(140.58±30.22)IU/L、(0.94±0.10) g/L和(0.98±0.09) g/L、(6.22±1.24) g/L和(6.48±1.31) g/L,明显高于对照组和SAP组;AMI组Gensini评分为(70.24±9.87)分,明显高于UAP组和SAP组;UAP组Gensini评分为(48.44±10.46)分,明显高于SAP组,差异均有统计学意义( P <0.05);RDW、PLR与cTnI呈正相关( r =0.322和0.311, P <0.05);GPⅥ与cTnI、CK-MB、Gensini评分呈正相关( r =0.307、0.322和0.297, P <0.05)。结论冠心病患者RDW、PLR及GPⅥ明显升高,与心肌损伤标记物存在相关性,其中GPⅥ与冠状动脉病变程度有一定关系。展开更多
目的探讨红细胞分布宽度(RDW)、血小板与淋巴细胞比值(PLR)、动脉血氧分压(PaO2)及动脉血二氧化碳分压(PaCO2)在慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压(PH)中的临床意义。方法选取2017年2月至2019年2月郑州大学第一附属医...目的探讨红细胞分布宽度(RDW)、血小板与淋巴细胞比值(PLR)、动脉血氧分压(PaO2)及动脉血二氧化碳分压(PaCO2)在慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压(PH)中的临床意义。方法选取2017年2月至2019年2月郑州大学第一附属医院收治的140例AECOPD患者为研究对象。根据心脏彩色多普勒超声所测得的肺动脉收缩压(SPAP),将入选患者分为A组(SPAP<40 mm Hg)80例和B组(SPAP≥40 mm Hg)60例,B组又分为轻度PH组42例和中重度PH组18例。所有入选患者于入院后24 h内留取静脉血标本,应用血细胞分析仪测定RDW、PLR值;于入院后2 h内静卧不吸氧或者停止吸氧30 min后,抽取桡动脉血行动脉血气分析,记录PaO2、PaCO2值,并比较不同组别间的RDW、PLR、PaO2、PaCO2水平及各指标间的相关性。结果 B组的RDW、PLR、PaCO2高于A组,差异有统计学意义(均P<0.05);B组的PaO2低于A组,差异有统计学意义(P<0.05)。中重度PH组血清RDW、PLR、PaCO2高于轻度PH组,中重度PH组PaO2低于轻度PH组,差异有统计学意义(均P<0.05)。相关性分析结果示,SPAP与RDW(r=0.437,P<0.001)、PLR(r=0.590,P<0.001)、PaCO2(r=0.400,P=0.002)之间存在正相关关系;SPAP与PaO2(r=-0.450,P<0.001)间存在负相关关系。结论 RDW、PLR、PaO2、PaCO2与AECOPD患者合并PH的发生及病情严重程度相关,为及早明确AECOPD患者合并PH及合并PH的病情严重程度提供了简便快捷的检测指标。展开更多
文摘BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.
文摘Objective:To investigate the diagnostic value of the monocyte-to-large-platelet ratio(MLPR),neutrophil-to-lymphocyte ratio(NLR),and red blood cell distribution width(RDW)for pulmonary embolism(PE)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 60 elderly AECOPD patients were enrolled and divided into embolus group(12 cases)and thrombus group(48 cases)according to whether they were combined with pulmonary embolism and the MLPR,NLR,and RDW values of the two groups were determined respectively.Results:The patients in the two groups had different degrees of vascular structural and functional abnormalities,and the MLPR,NLR,and RDW in the embolus group were significantly higher than those in the thrombus group(P<0.05);while the differences in NLR and RDW between the two groups were not significant.Conclusion:MLPR,NLR,and RDW can provide an objective basis for assessing PE in elderly AECOPD patients.
文摘目的研究中性粒细胞/淋巴细胞比值(N L R)、血小板/淋巴细胞比值(P L R)及红细胞分布宽度(RDW),在感染性休克的诊断、动态监测及预后评估中的临床意义。方法选择感染性休克患者155例(其中死亡组76例、治愈组79例),同期以健康体检人群155例作为阴性对照组。比较病例组与对照组在降钙素原(procalcitonin,PCT)、WBC、RDW、PLR及NLR之间的差异,分析各指标对感染性休克的诊断效率及其与PCT的相关性。比较死亡组与治愈组之间的差异,分析各指标与患者结局的相关性。结果 PCT、WBC、RDW、PLR、NLR在病例组与对照组比较差异均有统计学意义,NLR以4.68为诊断临界值,诊断灵敏度和特异度分别为96.1%和95.5%。PLR以14.62为诊断临界值,诊断灵敏度和特异度分别为72.3%和66.4%。PCT与NLR、PLR呈正相关(r=0.884,0.599)。感染性休克病例组中死亡率为49.03%,死亡组与治愈组比较PCT、RDW有差异。患者结局与PCT、RDW呈负相关(r=–0.165,–0.449)。不同时间段患者的PCT、WBC、PLR、NLR有差异,且PCT与NLR、PLR在不同时间段有明显相关性。结论 NLR、PLR与PCT呈明显正相关,可用于辅助诊断及动态监测感染性休克患者,RDW与患者结局呈明显负相关,对患者预后评估有一定的临床意义。
文摘目的:探讨中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)及红细胞分布宽度(red blood cell distribution width,RDW)对前列腺癌(prostate cancer,PCa)患者术后复发转移的价值。方法:选取2016年01月至2018年06月我院收治的PCa患者128例,根据其术后是否发生复发转移分为未复发转移组(n=78)和复发转移组(n=50)。采用Sysmex XN-3000全自动血细胞分析仪检测PCa患者NLR、PLR及RDW水平,分析其与临床病理特征的关系。应用受试者工作特征(receiver operating characteristic,ROC)曲线分析NLR、PLR及RDW预测PCa术后复发转移的价值。Pearson相关分析检测NLR、PLR及RDW之间的相关性。结果:复发转移组NLR(3.72±1.56 vs 2.38±1.14)、PLR(190.82±62.83 vs 158.42±43.70)及RDW[(13.85±1.24)%vs(12.74±0.96)%]水平均明显高于未复发转移组(P<0.01)。复发转移患者NLR、PLR及RDW水平与TNM分期、Gleason评分及分化程度相关(P<0.05)。ROC曲线分析显示,NLR、PLR及RDW预测PCa术后复发转移的最佳截值分别为3.06、181.42、13.28%,三项联合预测PCa术后复发转移的AUC(0.857,95%CI:0.795~0.916)最大,其敏感度和特异度为87.3%和82.0%。相关分析显示,复发转移患者NLR与PLR、RDW均呈正相关(r=0.758、r=0.625,P<0.01),PLR与RDW呈正相关(r=0.548,P<0.01)。结论:术前NLR、PLR及RDW水平升高与PCa术后复发转移有关,三项联合检测对预测PCa术后复发转移有一定的价值。
文摘目的探讨红细胞分布宽度(RDW)、血小板-淋巴细胞比值(PLR)及血小板胶原受体蛋白Ⅵ(GPⅥ)在冠心病中的水平及临床意义。方法选取2017年1—12月在我院治疗的冠心病患者104例,其中不稳定心绞痛37例(UAP组),心肌梗死32例(AMI组)和稳定型心绞痛35例(SAP组),同时选取健康自愿者40名作为对照组,检测各组RDW、PLR、GPⅥ等指标水平,同时采用Gensini评分评估各组病情。结果 UAP组和AMI组RDW、PLR、GPⅥ分别为(15.11±1.60)%和(15.03±1.89)%、(140.41±32.24)和(137.55±30.15)、(62.16±14.46) pg/mL和(60.70±15.51) pg/mL,明显高于对照组和SAP组;UAP组和AMI组肌酸激酶同工酶MB(CK-MB)、心肌肌钙蛋白T(cTnT)、心肌肌钙蛋白I(cTnI)分别为(132.44±24.44)IU/L 和(140.58±30.22)IU/L、(0.94±0.10) g/L和(0.98±0.09) g/L、(6.22±1.24) g/L和(6.48±1.31) g/L,明显高于对照组和SAP组;AMI组Gensini评分为(70.24±9.87)分,明显高于UAP组和SAP组;UAP组Gensini评分为(48.44±10.46)分,明显高于SAP组,差异均有统计学意义( P <0.05);RDW、PLR与cTnI呈正相关( r =0.322和0.311, P <0.05);GPⅥ与cTnI、CK-MB、Gensini评分呈正相关( r =0.307、0.322和0.297, P <0.05)。结论冠心病患者RDW、PLR及GPⅥ明显升高,与心肌损伤标记物存在相关性,其中GPⅥ与冠状动脉病变程度有一定关系。
文摘目的探讨红细胞分布宽度(RDW)、血小板与淋巴细胞比值(PLR)、动脉血氧分压(PaO2)及动脉血二氧化碳分压(PaCO2)在慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压(PH)中的临床意义。方法选取2017年2月至2019年2月郑州大学第一附属医院收治的140例AECOPD患者为研究对象。根据心脏彩色多普勒超声所测得的肺动脉收缩压(SPAP),将入选患者分为A组(SPAP<40 mm Hg)80例和B组(SPAP≥40 mm Hg)60例,B组又分为轻度PH组42例和中重度PH组18例。所有入选患者于入院后24 h内留取静脉血标本,应用血细胞分析仪测定RDW、PLR值;于入院后2 h内静卧不吸氧或者停止吸氧30 min后,抽取桡动脉血行动脉血气分析,记录PaO2、PaCO2值,并比较不同组别间的RDW、PLR、PaO2、PaCO2水平及各指标间的相关性。结果 B组的RDW、PLR、PaCO2高于A组,差异有统计学意义(均P<0.05);B组的PaO2低于A组,差异有统计学意义(P<0.05)。中重度PH组血清RDW、PLR、PaCO2高于轻度PH组,中重度PH组PaO2低于轻度PH组,差异有统计学意义(均P<0.05)。相关性分析结果示,SPAP与RDW(r=0.437,P<0.001)、PLR(r=0.590,P<0.001)、PaCO2(r=0.400,P=0.002)之间存在正相关关系;SPAP与PaO2(r=-0.450,P<0.001)间存在负相关关系。结论 RDW、PLR、PaO2、PaCO2与AECOPD患者合并PH的发生及病情严重程度相关,为及早明确AECOPD患者合并PH及合并PH的病情严重程度提供了简便快捷的检测指标。
