Abstract: Objective To explore the diagnostic and prognostic value of neutrophil/lymphocyte ratio (NLR) in chronic and acute hepatic failure associated with hepatitis B. Methods 102 patients with hepatitis B in our hospital from January 2016 to December 2018 were selected, 64 patients with hepatitis B cirrhosis and 38 patients with chronic and acute hepatic failure, and 100 healthy volunteers were selected as controls, the level of NLR was compared. Results The NLR of chronic and acute liver failure group were significantly higher than that of control group, chronic hepatitis B group and hepatitis B cirrhosis group (P<0.05). The area under ROC curve of NLR in NLR diagnosis of chronic and acute liver failure was 0.865, P<0.05, and the cut-off value was 3.28, the sensitivity and specificity were 86.50% and 70.50%. The NLR of death patients with chronic and acute liver failure was significantly higher than that of survival patients (P<0.05). The area under the ROC curve of NLR for predicting death in patients with chronic and acute liver failure was 0.806 (P<0.05), and the cut-off value was 3.61, the sensitivity was 88.90% and the specificity was 60.00%. Conclusion NLR has a good application value in the diagnosis and prognosis prediction of hepatitis B-related chronic and acute liver failure, and is worthy of clinical use.

Key words: neutrophil/lymphocyte ratio, hepatitis B-related chronic and acute liver failure, diagnosis, prognosis

摘要： 目的 探讨中性粒细胞/淋巴细胞比值（NLR）诊断乙肝相关慢加急性肝衰竭的临床预测价值。方法 选取2016年1月~2018年12月在我院治疗的乙肝患者102例,其中乙肝肝硬化患者64例,慢加急性肝衰竭患者38例,同时选取健康自愿者100例作为对照,比较各患者NLR水平差异。结果 与对照组、乙肝肝硬化组相比较,慢加急性肝衰竭组NL明显偏高（P<0.05）;诊断慢加急性肝衰竭的ROC曲线显示NLR的曲线下面积为0.865（P<0.05）,截断值为3.28,其灵敏度和特异度分别为86.50%和70.50%;慢加急性肝衰竭死亡患者NLR明显高于存活患者（P<0.05）;预测慢加急性肝衰竭患者死亡的ROC曲线显示NLR的曲线下面积为0.806（P<0.05）,截断值为3.61,其灵敏度为88.90%和特异度为60.00%。结论 NLR在乙肝相关慢加急性肝衰竭诊断及预后预测中有较好的应用价值,值得临床使用。

关键词: 中性粒细胞/淋巴细胞比值, 乙肝相关慢加急性肝衰竭, 诊断, 预后