中西医结合肝病杂志2025，Vol.35Issue(7)：823-827,5.DOI:10.3969/j.issn.1005-0264.2025.007.007
淋巴细胞与单核细胞比值联合整合终末期肝病模型评分对慢加急性肝衰竭患者的预测价值
Predictive value of LMR combined with iMELD score on 90 day prognosis of patients with chronic acute liver failure
摘要
Abstract
Objective:To investigate the value of lymphocyte-monocyte ratio(LMR)combined with iMELD score to predict the short-term prognosis of patients with acute-on-chronic liver Failure(ACLF).Methods:Retrospective analysis of clinical data of ACLF patients treated at the Third People's Hospital of Nantong City from January 2020 to August 2022.The patients were divided into survival group(n=87)and death group(n=66)according to their survival status at 90 days of follow-up,and the correlation between LMR combined with iMELD score and prognostic prediction model of ACLF was analyzed.Logistic regression was used to analyze the risk factors of death in ACLF patients.Pearson correlation test was used to analyze the correlation between LMR,prothrombin activity(PTA),and iMELD score.The receiver operating characteristic curve(ROC)was used to evaluate the clinical efficacy of LMR combined with iMELD on the prognosis of ACLF patients.Results:A total of 153 ACLF patients were included,of which 66 died within 90 days.The LMR,PTA,and monocyte count were all greater in the surviving group than in the dying group,and the differences were statistically significant(P＜0.05).The creatinine,INR,MELD score,MELD-Na score,and iMELD score were all higher in the dying group than in the surviving group,and the differences were statistically significant(P＜0.05).Pearson correlation analysis showed that LMR was positively correlated with PTA score(r=0.174,P=0.002)and negatively correlated with MELD score(r=-0.243,P=0.003),MELD-Na score(r=-0.255,P=0.002),and iMELD score(r=-0.254 P=0.002).The area under the ROC curve of the combined LMR and iMELD scores was 0.849,which was higher than that of the individual tests.Conclusion:The LMR and iMELD scores are important parameters affecting the prognosis of ACLF patients,and the combination of LMR and iMELD scores can improve the predictive value of the prognosis of ACLF patients,which has certain clinical significance.关键词
慢加急性肝衰竭/淋巴细胞计数与单核细胞计数比值/iMELD/预后Key words
acute-on-chronic liver failure/lymphocyte-monocyte ratio/iMELD/prognosis分类
医药卫生引用本文复制引用
薛红,张莉,丁伟,邵建国,卞兆连..淋巴细胞与单核细胞比值联合整合终末期肝病模型评分对慢加急性肝衰竭患者的预测价值[J].中西医结合肝病杂志,2025,35(7):823-827,5.基金项目
南通市科技局项目(No.JC2023115),江苏省"六大人才高峰"培养项目(No.YY-177),江苏省第五期"333工程"科研资助立项项目(No.BRA2020196) （No.JC2023115）
