■乙型肝炎病毒相关的慢性急性肝衰竭(HBV-ACLF)是与不利的生存率相关的危急情况。最近的研究表明,血小板与单核细胞的比率(PMR)被认为是几种疾病的有效预后指标。然而,尚无研究评估PMR在HBV-ACLF患者中的预后价值。因此,本研究旨在调查这些患者PMR与28天生存率之间的关系.
■在这项回顾性研究中,数据,包括临床和实验室参数,收集了184例HBV-ACLF患者。使用终末期肝病模型(MELD)评分评估疾病严重程度。进行Logistic回归分析以确定影响28天生存率的预测因子。进行受试者工作特征曲线(ROC)分析以评估所识别的预测因子的预测能力。
■在28天的随访期间,56例(30.4%)HBV-ACLF患者死亡。非存活者的PMR显著低于存活者(P<0.001)。Logistic回归表明,PMR(赔率,0.983;95%置信区间,0.976-0.990;P=0.001)和MELD评分(赔率,1.317;95%置信区间,1.200-1.446;P<0.001)是HBV-ACLF患者死亡的独立危险因素。PMR的ROC曲线下面积为0.760(敏感性=0.840,特异性=0.620,P=0.001),截止值为23.1,MELD评分的ROC曲线下面积为0.819(敏感性=0.700,特异性=0.860,P=0.001)。PMR和MELD评分表现相似(Z=1.229;P=0.219)。此外,联合使用PMR和MELD评分可使ROC曲线下面积进一步增加至0.858,比单独使用任一因素更准确预测预后(均P<0.05)。
■PMR可以作为预测HBV-ACLF患者死亡率的可靠工具。此外,将PMR与MELD评分相结合可以提高预测这些患者28日死亡率的预后准确性.然而,我们需要进一步的更大规模的研究来证实我们的发现.
UNASSIGNED: Hepatitis B virus-related acute-on-chronic liver failure (HBV-
ACLF) is a critical condition associated with unfavorable survival rates. Recent studies have indicated that the platelet-to-monocyte ratio (PMR) is considered an effective prognostic marker in several diseases. However, there has been no study to evaluate the prognostic value of PMR in HBV-
ACLF patients. Therefore, this study aimed to investigate the association between PMR and 28-day survival in these patients.
UNASSIGNED: In this retrospective study, data, including clinical and laboratory parameters, were collected for 184 HBV-
ACLF patients. Disease severity was assessed using the Model for End-Stage Liver Disease (MELD) score. Logistic regression analyses were conducted to identify predictors influencing 28-day survival. Receiver-operating characteristic curve (ROC) analyses were performed to assess the predictive abilities of the identified predictors.
UNASSIGNED: During the 28-day follow-up period, 56 (30.4%) HBV-
ACLF patients died. PMR was significantly lower in non-survivors than in survivors (P <0.001). Logistic regression demonstrated that PMR (Odds ratio, 0.983; 95% Confidence interval, 0.976-0.990; P=0.001) and MELD score (Odds ratio, 1.317; 95% Confidence interval, 1.200-1.446; P <0.001) were independent risk factors for mortality in HBV-
ACLF patients. The area under ROC curve for PMR was 0.760 (sensitivity=0.840, specificity=0.620, P=0.001) at a cut-off value of 140.6, and the area under ROC curve for MELD score was 0.819 (sensitivity=0.700, specificity=0.860, P=0.001) at a cut-off value of 23.1. PMR and MELD score exhibited similar predictive performances (Z=1.229; P=0.219). Furthermore, the combined use of PMR and MELD score further increased the area under the ROC curve to 0.858, which more accurate prognosis prediction than use of either factor alone (both P< 0.05).
UNASSIGNED: The PMR could serve as a reliable tool for predicting mortality in HBV-ACLF patients. Additionally, combining the PMR with the MELD score could improve prognostic accuracy for predicting 28-day mortality in these patients. However, further and larger studies are needed to confirm our findings.