本文選題：中性粒細(xì)胞　切入點(diǎn)：淋巴細(xì)胞　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:中性粒細(xì)胞淋巴細(xì)胞比值(neutrophil-to-lymphocyte ratio,NLR)是一個(gè)新的炎癥指標(biāo),臨床上可預(yù)測(cè)疾病的預(yù)后。炎癥反應(yīng)在乙肝病毒感染者病情加重的過(guò)程中起著重要的作用,本文就NLR在預(yù)測(cè)其病情演變中的作用進(jìn)行了初步的研究。方法:總共收集了349例研究對(duì)象的資料,其中包括體檢中心的健康人60例(A組),慢性乙型肝炎重度111例(B組),乙肝肝硬化失代償期92例(C組),慢加急性肝衰竭(acute-on-chronic liver failure,ACLF)86例(D組)。收集患者的血常規(guī),肝功能,凝血功能結(jié)果,計(jì)算其NLR。根據(jù)病情進(jìn)展情況將B組分為B1組(16例,進(jìn)展為ACLF)和B2組(95例,未進(jìn)展為ACLF)。分析各組間NLR值的差異,并進(jìn)行預(yù)后的預(yù)測(cè)分析。采用SPSS 20.0統(tǒng)計(jì)分析軟件進(jìn)行組間比較、相關(guān)性等統(tǒng)計(jì)分析,以P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:(1)A、B、C、D組NLR值分別為2.22(1.76,3.05),2.54(1.78,3.49),3.07(1.95,5.04),3.41(2.01,5.15)。隨著病情的加重,NLR值逐漸增加。(2)B組中有16例進(jìn)展為ACLF(B1組),95例仍為慢性乙型肝炎重度(B2組),通過(guò)單因素和多因素回歸分析得出,NLR和PTA是影響疾病進(jìn)展的預(yù)后因素。比較B1組和B2組入組時(shí)的NLR,差異有統(tǒng)計(jì)學(xué)意義(3.97±1.54VS2.71±1.54,P=0.004)。16例慢性乙型肝炎重度患者進(jìn)展為ACLF時(shí),其對(duì)應(yīng)的NLR是明顯增加的(P0.05)。通過(guò)ROC曲線分析,慢性乙型病毒性肝炎重度進(jìn)展成ACLF的cut-off值為2.79(AUC:0.739,P=0.002)。(3)NLR預(yù)測(cè)患者為終末期肝病(end-stage liver disease,ESLD)的cut-off值為3.94(AUC:0.612,P=0.001)。(4)相關(guān)性分析顯示NLR與PTA、ALB呈負(fù)相關(guān)(P0.001),但與TB則呈正相關(guān)。結(jié)論:外周血NLR可以反映病情進(jìn)展,并預(yù)測(cè)肝衰竭的發(fā)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 鹵1.54VS2.71 鹵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.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R512.62

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相關(guān)期刊論文 前10條

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本文編號(hào)：1674974