血清标志物在各种原因引起肝衰竭预测预后和临床结局中的作用

肝脏 ›› 2020, Vol. 25 ›› Issue (12): 1258-1261.

血清标志物在各种原因引起肝衰竭预测预后和临床结局中的作用

罗万蓉, 徐玉敏, 陈学兵, 陈皋, 史冬梅, 谢青

200025 四川省德阳市人民医院感染科(罗万蓉,陈学兵,陈皋);上海交通大学医学院附属瑞金医院感染科(徐玉敏,史冬梅,谢青)

收稿日期:2020-06-04 出版日期:2020-12-31 发布日期:2021-02-26
通讯作者: 徐玉敏,Email:xym121@163.com
基金资助:
上海市临床重点专科(感染病学)( shslczdzk01103);国家自然科学基金(81770587);十三五“科技部重大专项”(2017ZX10203201-008,2017ZX10202202-005-004,2018ZX09206005-004)

The role of serum markers in predicting the prognosis and clinical outcome of liver failure caused by various etiologies

LUO Wan-rong¹, XU Yu-min², CHEN Xue-bing¹, CHEN Gao¹, SHI Dong-mei², XIE Qing²

1. Department of Infection,People's Hospital of Deyang City,Sichuan 618000,China;
2. Department of Infection, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200025, China

Received:2020-06-04 Online:2020-12-31 Published:2021-02-26
Contact: XU Yu-min,Email:xym121@163.com

摘要/Abstract

摘要： 目的探讨不同病因肝衰竭早期血清前白蛋白水平、中性粒细胞与淋巴细胞比值以及MELD-Na评分对肝衰竭早期预警的影响。方法选择2017年1月至2019年12月上海交通大学医学院附属瑞金医院感染科收治的不同病因肝衰竭患者100例,回顾性分析患者临床资料,根据其临床转归,分为好转组(51例)和预后不佳组(49例)。比较两组血清前白蛋白水平、中性粒细胞与淋巴细胞比值及MELD-Na评分水平,分析这些指标与疾病早期预后关系。组间比较采用t检验、χ²检验。结果好转组血清前白蛋白水平明显高于预后不佳组(65.08比51.02,P<0.05),中性粒细胞及淋巴细胞比值(NLR)、MELD-Na评分均明显低于预后不佳组(分别为4.00比5.69/21.40比28.02,均P<0.05)。在不同水平血清前白蛋白、中性粒细胞与淋巴细胞比值(NLR)及MELD-Na评分区间,好转组与预后不佳组发生率差异均有统计学意义(P<0.05)。结论血清前白蛋白、中性粒细胞与淋巴细胞比值及MELD-Na评分与肝衰竭预后相关。

关键词: 肝衰竭, 血清前白蛋白, 中性粒细胞与淋巴细胞比值(NLR), MELD-Na评分, 预后

Abstract: Objective To investigate the predictive value of serum prealbumin level, neutrophil lymphocyte ratio (NLR), and MELD-Na score on the outcome of patients with early stage of liver failure induced by various etiologies.Methods 100 patients with liver failure due to various etiologies were studied. The clinical data of patients were retrospectively collected. The patients were divided into improved group (51 cases) and poor prognosis group (49 cases) based on their clinical outcomes. The levels of serum prealbumin, neutrophil lymphocyte ratio (NLR) and MELD-Na score at admission were compared between these two groups. The association between these indicators with the early prognosis of the disease was analyzed. T-test was used for the measurement data and χ² test was used for counting data. Correlation analysis was performed with SPSS 25.0 software. P<0.05 was considered statistically significant.Results Serum prealbumin level in the improved group at admission was significantly higher than that in the poor prognosis group (65.08 vs 51.02, P<0.05). The neutrophil and lymphocyte ratio (NLR) and MELD-Na score were significantly lower than those in the poor prognosis group (4.00 vs 5.69, 21.40 vs 28.02, P<0.05). There were significant differences in stratification analysis of serum prealbumin, neutrophil lymphocyte ratio (NLR) and MELD-Na score between the improvement group and the poor prognosis group (P<0.05).Conclusion Serum prealbumin, neutrophil lymphocyte ratio (NLR) and MELD-Na score are associated with the prognosis. Early assessment can help to early predict the prognosis of liver failure with accuracy.

Key words: Liver failure, Serum prealbumin, Neutrophil to lymphocyte ratio (NLR), MELD-Na score, Prognosis

罗万蓉, 徐玉敏, 陈学兵, 陈皋, 史冬梅, 谢青. 血清标志物在各种原因引起肝衰竭预测预后和临床结局中的作用[J]. 肝脏, 2020, 25(12): 1258-1261.

LUO Wan-rong, XU Yu-min, CHEN Xue-bing, CHEN Gao, SHI Dong-mei, XIE Qing. The role of serum markers in predicting the prognosis and clinical outcome of liver failure caused by various etiologies[J]. Chinese Hepatolgy, 2020, 25(12): 1258-1261.

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