外周血中性粒细胞淋巴细胞比值在乙肝病毒感染者病情演变中的作用

发布时间：2018-03-28 05:28

本文选题：中性粒细胞　切入点：淋巴细胞　出处：《重庆医科大学》2017年硕士论文

【摘要】：目的:中性粒细胞淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)是一个新的炎症指标,临床上可预测疾病的预后。炎症反应在乙肝病毒感染者病情加重的过程中起着重要的作用,本文就NLR在预测其病情演变中的作用进行了初步的研究。方法:总共收集了349例研究对象的资料,其中包括体检中心的健康人60例(A组),慢性乙型肝炎重度111例(B组),乙肝肝硬化失代偿期92例(C组),慢加急性肝衰竭(acute-on-chronic liver failure,ACLF)86例(D组)。收集患者的血常规,肝功能,凝血功能结果,计算其NLR。根据病情进展情况将B组分为B1组(16例,进展为ACLF)和B2组(95例,未进展为ACLF)。分析各组间NLR值的差异,并进行预后的预测分析。采用SPSS 20.0统计分析软件进行组间比较、相关性等统计分析,以P0.05为差异有统计学意义。结果:(1)A、B、C、D组NLR值分别为2.22(1.76,3.05),2.54(1.78,3.49),3.07(1.95,5.04),3.41(2.01,5.15)。随着病情的加重,NLR值逐渐增加。(2)B组中有16例进展为ACLF(B1组),95例仍为慢性乙型肝炎重度(B2组),通过单因素和多因素回归分析得出,NLR和PTA是影响疾病进展的预后因素。比较B1组和B2组入组时的NLR,差异有统计学意义(3.97±1.54VS2.71±1.54,P=0.004)。16例慢性乙型肝炎重度患者进展为ACLF时,其对应的NLR是明显增加的(P0.05)。通过ROC曲线分析,慢性乙型病毒性肝炎重度进展成ACLF的cut-off值为2.79(AUC:0.739,P=0.002)。(3)NLR预测患者为终末期肝病(end-stage liver disease,ESLD)的cut-off值为3.94(AUC:0.612,P=0.001)。(4)相关性分析显示NLR与PTA、ALB呈负相关(P0.001),但与TB则呈正相关。结论:外周血NLR可以反映病情进展,并预测肝衰竭的发生。
[Abstract]:Objective: neutrophil-to-lymphocyte ratio (neutrophil-to-lymphocyte) is a new inflammatory marker, which can predict the prognosis of the disease clinically. Inflammatory reaction plays an important role in the process of exacerbation of hepatitis B virus infection. This paper makes a preliminary study on the role of NLR in predicting the development of its disease. Methods: a total of 349 cases were collected. There were 60 healthy persons in the physical examination center, 111 patients with severe chronic hepatitis B, 92 patients with decompensated hepatitis B and 86 patients with acute liver failure. Blood routine examination and liver function were collected. According to the progress of the disease, group B was divided into group B1 (n = 16) and group B2 (n = 95). SPSS 20.0 statistical analysis software was used to carry out the statistical analysis of inter-group comparison, correlation and so on. Results the NLR value of group D was 2.22 / 1.766 / 3.05 and 2.54 / 1.83.49 / 3.071.955.04 / 3.41 / 2.41 / 2. 01 / 2.15 respectively. With the exacerbation of the disease, 16 cases in group B developed into ACLF(B1 group, 95 cases were still chronic hepatitis B / B group (n = 95), through univariate and multifactorial factors. The regression analysis showed that NLR and PTA were the prognostic factors influencing the progression of chronic hepatitis B. the difference between group B1 and group B2 was statistically significant (3.97 卤1.54VS2.71 卤1.54). 16 patients with severe chronic hepatitis B had progression to ACLF. The corresponding NLR is a significant increase of P0. 05%. The ROC curve analysis shows that. The cut-off value of ACLF in patients with severe progression of chronic hepatitis B to ACLF was 2.79% AUC: 0.739p 0.739p 0.002nLR for predicting end-stage liver disease of patients with end-stage liver disease (cut-off = 3.94 AUC: 0.612P 0.001n.4.) correlation analysis showed that NLR was negatively correlated with ACLF, but positively correlated with TB. Conclusion: peripheral blood NLR can be negatively correlated with NLR and TB. Conclusion: peripheral blood NLR can be positively correlated with PTA-ALB. Conclusion: peripheral blood NLR can be negatively correlated with PTA-ALB. Conclusion: peripheral blood NLR can be positively correlated with NLR, but it is positively correlated with TB.Conclusion: peripheral blood NLR can be positively correlated with NLR. To reflect the progress of the disease, The occurrence of liver failure was predicted.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.62

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