摘要
目的 探讨血常规中中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）、红细胞分布宽度与血小板比值（RPR）、红细胞分布宽度与淋巴细胞比值（RLR）、血小板与淋巴细胞比值（PLR）等炎性标志物对失代偿期肝硬化上消化道出血的预测价值。方法 选取2020-2023年在云南省第三人民医院消化内科住院的失代偿期肝硬化患者200例，根据有无上消化道出血，分为出血组（100例）和非出血组（100例）。首先计算NLR、LMR、RPR、RLR、PLR比值，通过两独立样本非参数检验方法比较以上5种炎性标记物在出血组和非出血组之间是否存在差异，绘制ROC曲线，筛选出对失代偿期肝硬化上消化道出血具有预测价值的指标。结果 PLR的P值为（p＜0.061）、NLR的P值为（p＜0.000）、LMR的P值为（p＜0.052）、RPR的P值为（p＜0.091）、RLR的P值为（p＜0.002），故NLR、RLR两种炎性标志物对失代偿期肝硬化上消化道出血具有预测价值（P＜0.05）；绘制ROC曲线分析得出：PLR、NLR、LMR、RPR、RLR曲线下面积分别为0.577、0.663、0.580、0.569、0.628，故NLR、RLR对失代偿期肝硬化上消化道出血具有更高的预测价值。结论 NLR、LMR、RPR、RLR、PLR对失代偿期肝硬化上消化道出血具有预测价值，NLR、RLR对失代偿期肝硬化上消化道出血预测价值更高。
关键词： NLR；LMR；RPR；RLR；PLR；失代偿期肝硬化；上消化道出血
Abstract
Objective To investigate the predictive value of neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), red blood cell to platelet ratio (RPR), red blood cell to lymphocyte ratio (RLR), platelet to lymphocyte ratio (PLR) and other inflammatory markers in upper gastrointestinal bleeding in decompensated cirrhosis . Methods 200 patients with decompensated cirrhosis admitted to the Department of Gastroenterology, the Third People's Hospital of Yunnan Province from 2020 to 2023 were selected and divided into bleeding group (100 cases) and non-bleeding group (100 cases) according to the absence of gastrointestinal bleeding. First, the ratios of NLR, LMR, RPR, RLR and PLR were calculated, and the differences of the above 5 inflammatory markers between the bleeding group and the non-bleeding group were compared by the non-parametric test method of two independent samples, and the ROC curve was drawn to screen out the indicators with predictive value for upper gastrointestinal bleeding in decompensated cirrhosis. Result The P value of PLR is (p < 0.061), the P value of NLR is (p < 0.000), the P value of LMR is (p < 0.052), the P value of RPR is (p < 0.091), and the P value of RLR is (p < 0.002). Therefore, the two inflammatory markers of NLR and RLR had predictive value for upper gastrointestinal bleeding in decompensated cirrhosis (P < 0.05). ROC curve analysis showed that the areas under PLR, NLR, LMR, RPR and RLR curves were 0.577, 0.663, 0.580, 0.569 and 0.628, respectively. Therefore, NLR and RLR had higher predictive value for upper gastrointestinal bleeding in decompensated cirrhosis. Conclusion NLR, LMR, RPR, RLR and PLR have predictive value for upper gastrointestinal hemorrhage in decompensated cirrhosis, and NLR and RLR have higher predictive value for upper gastrointestinal hemorrhage in decompensated cirrhosis.
Key words： NLR; LMR; RPR; RLR; PLR; Decompensated cirrhosis; Upper gastrointestinal bleeding
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