Value of neutrophil-lymphocyte ratio in predicting hepatitis B-related liver failure
10.3760/cma.j.issn.1007-3418.2017.10.002
- VernacularTitle: 中性粒细胞淋巴细胞比值在预测乙型肝炎相关肝衰竭中的作用
- Author:
Yue FAN
1
;
Xin LI
;
Xiaofang ZHOU
;
Dazhi ZHANG
;
Xiaofeng SHI
Author Information
1. Department of Infectious Diseases, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
- Publication Type:Journal Article
- Keywords:
Hepatitis B, chronic;
Liver cirrhosis;
Liver failure;
Neutrophil;
Lymphocyte
- From:
Chinese Journal of Hepatology
2017;25(10):726-731
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of neutrophil-lymphocyte ratio (NLR) in predicting hepatitis B-related liver failure.
Methods:A total of 349 subjects were enrolled, among whom 60 were healthy persons who underwent physical examination (group A), 111 had severe chronic hepatitis B (group B), 92 had decompensated hepatitis B cirrhosis (group C), and 86 had acute-on-chronic liver failure (ACLF) (group D). Routine blood test results, liver function parameters, and coagulation parameters were collected, and NLR was calculated. According to disease progression, group B was further divided into groups B1 (with progression to ACLF) and B2 (without progression to ACLF). NLR was compared between groups, and its prognostic value was evaluated.
Results:NLR was 2.22(1.76-3.05) in group A, 2.54(1.78-3.49) in group B, 3.07(1.95-5.04)in group C, and 3.41(2.01-5.15) in group D, and NLR gradually increased with the aggravation of disease condition. The univariate and multivariate regression analyses of groups B1 and B2 showed that NLR and prothrombin activity were prognostic factors for disease progression. There was a significant difference in baseline NLR between groups B1 and B2 (3.87 ± 1.54 vs 2.71 ± 1.54, P = 0.004). There was a significant increase in NLR when severe hepatitis B in 16 patients progressed to ACLF (P = 0.042). The receiver operating characteristic (ROC) curve analysis showed that the cut-off value of NLR for predicting the progression of severe hepatitis B to ACLF was 2.79, with an area under the ROC curve (AUC) of 0.739 (P = 0.002). NLR was also a reference index for judging end-stage liver disease with a cut-off value of 3.94 (AUC = 0.612, P = 0.001).
Conclusion:Peripheral NLR can reflect disease progression and predict the development of liver failure.
