乙型肝炎肝硬化患者外周血dNLR、MLR和SII变化及其临床意义分析*

doi:10.3969/j.issn.1672-5069.2023.01.019

摘要/Abstract

摘要： 目的探讨乙型肝炎肝硬化患者外周血衍生中性粒细胞/淋巴细胞比值(dNLR)、单核细胞/淋巴细胞比值(MLR)和系统性免疫性炎症指数(SII)变化及其临床意义。方法 2019年1月～2021年12月我院收治的乙型肝炎肝硬化患者85例和慢性乙型肝炎(CHB)患者85例,采用ELISA法检测血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和IL-17。常规检测血细胞计数。结果乙型肝炎肝硬化患者血清TBIL和INR分别为(43.1±8.5)μmol/L和(1.3±0.6),显著高于【分别为(19.4±3.0)μmol/L和(1.1±0.2),P＜0.05】,而血清ALT和ALB水平分别为(63.6±8.2)U/L和(30.8±4.6)g/L,显著低于CHB组【分别为(104.1±14.9)U/L和(39.0±8.1)g/L,P＜0.05】;肝硬化患者血清TNF-α、IL-6和IL-17水平分别为(88.7±11.6)pg/mL、(95.6±12.5)pg/mL和(45.6±8.9)ng/mL,显著高于CHB组【分别为(68.2±9.3)pg/mL、(67.9±9.5)pg/mL和(25.5±5.1)ng/mL,P＜0.05】 ;肝硬化患者外周血dNLR、MLR和SII分别为(2.2±0.5)、0.8(0.7,0.9)和(553.9±83.4),显著高于CHB组【分别为(1.8±0.3)、0.6(0.5,0.7)和(481.4±99.3),P＜0.05】;Child B/C级乙型肝炎肝硬化患者外周血dNLR、MLR和SII显著高于A级乙型肝炎肝硬化患者(P＜0.05),Child C级乙型肝炎肝硬化患者外周血dNLR、MLR和SII显著高于B级乙型肝炎肝硬化患者(P＜0.05)。结论乙型肝炎肝硬化患者外周血dNLR、MLR和SII显著升高,且它们的变化与病情严重程度有关。

关键词: 肝硬化, 衍生中性粒细胞/淋巴细胞比值, 单核细胞/淋巴细胞比值, 系统性免疫性炎症指数, Child-Pugh分级

Abstract: Objective The aim of this study was to explore the clinical implication of peripheral blood derived neutrophil to lymphocyte ratio (dNLR), monocyte to lymphocyte ratio (MLR) and systemic immune inflammatory index (SII) in patients with hepatitis B liver cirrhosis(LC). Methods 85 patients with hepatitis B-induced LC and 85 patients with chronic hepatitis B (CHB) were encountered in our hospital between January 2019 and December 2021. Serum tumor necrosis factor -α(TNF-α), interleukin-6 (IL-6) and IL-17 levels were detected by ELISA. The peripheral blood platelet, lymphocyte, neutrophil and monocyte counts were detected by full-automatic blood cell analyzer. Results Serum bilirubin level and INR in patients with LC were(43.1±8.5)μmol/L and (1.3±0.6), much higher than [(19.4±3.0)μmol/L and (1.1±0.2), P＜0.05], while serum ALT and albumin levels were (63.6±8.2)U/L and (30.8±4.6)g/L, much lower than [(104.1±14.9)U/L and (39.0±8.1)g/L, respectively, P＜0.05] in patients with CHB; serum TNF-α, IL-6 and IL-17 levels in patients with LC were (88.7±11.6)pg/mL, (95.6±12.5)pg/mL and (45.6±8.9)ng/mL, significantly higher than [(68.2±9.3)pg/mL, (67.9±9.5)pg/mL and (25.5±5.1)ng/mL, respectively, P＜0.05] in patients with CHB; the dNLR, MLR and SII in patients with (2.2±0.5), 0.8(0.7, 0.9) and (553.9±83.4), significantly higher than [(1.8±0.3), 0.6(0.5, 0.7) and (481.4±99.3), P＜0.05] in patients with CHB; the dNLR, MLR and SII in LC patients with Child class B/C were significantly higher than in those with Child class A(P＜0.05), and the dNLR, MLR and SII in patients with Child class C were significantly higher than in patients with Child class B (P＜0.05). Conclusion The peripheral blood dNLR, MLR and SII significantly increase in patients with hepatitis B cirrhosis, and their changes are related to disease severity.

Key words: Liver cirrhosis, Derived neutrophil to lymphocyte ratio, Monocyte to lymphocyte ratio, Systemic immune inflammatory index, Child-Pugh classification

徐海波, 苏惠婷, 熊异平, 徐远久, 邓强. 乙型肝炎肝硬化患者外周血dNLR、MLR和SII变化及其临床意义分析^*[J]. 实用肝脏病杂志, 2023, 26(1): 71-74.

Xu Haibo, Su Huiting, Xiong Yiping, et al. Changes of peripheral blood dNLR, MLR and SII in patients with hepatitis B cirrhosis[J]. Journal of Practical Hepatology, 2023, 26(1): 71-74.

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乙型肝炎肝硬化患者外周血dNLR、MLR和SII变化及其临床意义分析^*

Changes of peripheral blood dNLR, MLR and SII in patients with hepatitis B cirrhosis

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