肝脏 ›› 2018, Vol. 23 ›› Issue (6): 492-495.

• 论著 • 上一篇    下一篇

SII、NLR对于恶性梗阻性黄疸患者PTCD胆道金属支架置入术后生存时间的影响

袁小凌, 白玉盘, 尹东林, 洪晟镇, 包玉洁, 周园园, 焉雷, 康耀月, 范珊, 曹俊英, 许洁   

  1. 201999 上海交通大学医学院附属第九人民医院感染科
  • 收稿日期:2018-02-05 发布日期:2020-04-26
  • 通讯作者: 许洁,Email:dr.xu@aliyun.com

Influence of SII and NLR on the survival time in patients with malignant obstructive jaundice treated with PTCD implantation of biliary mental stents

YUAN Xiao-ling, Bai Yu-pan, YIN Dong-lin, HONG Shen-zhen, Bao Yu-jie, ZHOU Yuan-yuan, YAN Lei, KANG Yao-yue, FAN Shan, CAO Jun-ying, XU Jie   

  1. Department of Infectious Disease, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medcine, Shanghai 201999, China
  • Received:2018-02-05 Published:2020-04-26
  • Contact: Xu Jie, Email: dr.xu@aliyun.com

摘要: 目的 分析炎性因子对恶性梗阻性黄疸PTCD胆道金属支架置入术后生存时间的影响。方法 回顾14例行PTCD胆道金属支架置入术的恶性梗阻性黄疸患者。比较术前、术后1周、术后1个月和术后4个月患者的ALT、AST、TBil、Alb水平。术前的基线数据用来计算患者炎症相关因子,包括SII、PLR、NLR、MLR。用Kaplan-Meier方法和Cox模型分析累积生存率。结果 ALT、AST、TBil在PTCD胆道金属支架置入术后明显下降,而白蛋白水平在术后4月较前上升。术后中位随访时间10个月,7例患者死亡。通过log-rank检测和Cox模型分析,SII和NLR和患者生存率相关。结论 PTCD胆道支架置入是对于恶性梗阻性黄疸患者是个较好的临床治疗方法,SII和NLR水平的增高和低生存率相关。

关键词: 恶性梗阻性黄疸, 总生存率, PTCD, 系统免疫炎症指数, 中性淋巴细胞比率

Abstract: Objective To analyze the influence of inflammatory factors in patients with malignant obstructive jaundice (MOJ) implanted with biliary mental stents by percutaneous transhepatic cholangial drainage (PTCD). Methods Fourteen patients with MOJ treated with implantation of biliary mental stents by PTCD were enrolled. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and albumin were compared before and after implantation (at week 1, month 1 and 4). Preoperative clinical data were collected to calculate the inflammation indexes, including systemic immune-inflammation index (SII, neutrophil × platelets / lymphocyte), platelets-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio. Overall survival (OS) was estimated by the Kaplan-Meier method and Cox regression analysis. Results Levels of ALT, AST and TBil were significantly decreased after implantation operation, while albumin level was increased at month 4 after operation. During a median follow-up time of 10 months, 7 (50%) patients died. Additionally, SII and NLR were found to be associated with OS. Conclusion PTCD implantation of biliary mental stents is clinically feasible for patients with MOJ, and increased levels of SII and NLR are associated with poor OS after operation.

Key words: Malignant obstructive jaundice, Overall survival, Percutaneous transhepatic cholangial drainage, Systemic immune-inflammation index, Neutrophil-to-lymphocyte ratio