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当前位置：国际临床研究杂志 > 2026年 10卷 (5)期

Open Access Article

International Journal of Clinical Research. 2026; 10: (5) ; 17-29 ; DOI: 10.12208/j.ijcr.20260228.

Predictive value of NLR, PTAR combined with MELD-Na score for mid-and long-term prognosis in patients with decompensated liver cirrhosis
NLR、PTAR联合MELD-Na评分对失代偿期肝硬化患者中长期预后的预测价值

作者： 张顺玲¹, 郑盛² *, 殷芳², 刘佩¹, 曾雪丽¹, 李心怡¹

1 大理大学临床医学院云南大理;

2 大理大学第二附属医院（云南省第三人民医院）消化内科云南昆明;

*通讯作者：郑盛,单位：大理大学第二附属医院（云南省第三人民医院）消化内科云南昆明；

云南省教育厅科研基金（研究生类）（项目编号：2025Y1179）云南省地方高校（部分）基础研究联合专项面上项目（项目编号：202301BA070001-029，202301BA070001-044）云南省高层次科技人才及创新团队选拔专项-中青年学术和技术带头人后备人才项目（项目编号：202405AC350067）

发布时间: 2026-05-22 总浏览量: 41

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摘要

目的探讨中性粒细胞计数/淋巴细胞计数（neutrophil-to-lymphocyte ratio, NLR）与凝血酶原时间国际标准化比值/白蛋白（international normalized ratio to albumin ratio, PTAR）联合MELD-Na评分对失代偿期肝硬化患者中长期预后的预测价值。方法回顾性分析2020年1月至2024年7月大理大学第二附属医院收治的171例失代偿期肝硬化患者作为研究对象。根据随访12个月的预后情况分为生存组（99例）和死亡组（72例）。收集患者基线资料、实验室资料、影像学资料，计算NLR、PTAR比值及MELD-Na评分；比较两组间各指标的差异；通过二元Logistic回归分析筛选出影响失代偿期肝硬化患者中长期预后的独立危险因素；利用受试者工作特征曲线（ROC）评估NLR、PTAR联合MELD-Na评分对失代偿期肝硬化患者中长期预后的预测效能。结果 CTP分级、病因、ALT、Na+、LDL、D-Di、门静脉内径、脾脏厚度、NLR、PTAR、MELD-Na评分是影响失代偿期肝硬化患者中长期预后的独立危险因素; 绘制ROC曲线结果显示：NLR、PTAR、MELD-Na评分单一及联合预测失代偿期肝硬化患者中长期预后的AUC分别为0.800（95%CI：0.732～0.868）、0.849（95%CI：0.792～0.907）、0.788（95%CI：0.720～0.857）和0.887（95%CI：0.838～0.937），对应的灵敏度分别为80.6%、76.4%、72.1%和88.9%；特异度分别为72.7%、81.8%、74.7%和71.7%。结论 NLR、PTAR及MELD-Na评分是失代偿期肝硬化患者中长期预后的独立危险因素，三者联合预测效能显著高于单一检测。

关键词： 失代偿期肝硬化；中性粒细胞计数；淋巴细胞计数；凝血酶原时间国际标准化比值；白蛋白；MELD-Na评分

Abstract

Objective To investigate the predictive value of Neutrophil-to-Lymphocyte Ratio (NLR) and Prothrombin Time International Normalized Ratio to Albumin Ratio (PTAR) combined with the Model for End-Stage Liver Disease-Sodium (MELD-Na) score for the mid-and long-term prognosis in patients with decompensated liver cirrhosis.
Methods A retrospective analysis was conducted on 171 patients with decompensated cirrhosis admitted to the Second Affiliated Hospital of Dali University between January 2020 and July 2024. Based on 12-month follow-up outcomes, patients were categorized into survival (n=99) and death (n=72) groups. Baseline demographics, laboratory findings, and imaging data were collected to calculate NLR, PTAR, and MELD-Na scores. Inter-group comparisons were performed, followed by binary Logistic regression to identify independent prognostic risk factors. The predictive performance of NLR and PTAR combined with MELD-Na score was assessed using receiver operating characteristic (ROC) curve analysis.
Results Child-Turcotte-Pugh (CTP) classification, etiology, alanine aminotransferase (ALT), serum sodium (Na+), low-density lipoprotein (LDL), D-dimer (D-Di), portal vein diameter, splenic thickness, NLR, PTAR and MELD-Na score were independent risk factors for the mid-and long-term prognosis of patients with decompensated liver cirrhosis. The ROC curve analysis showed that the areas under the curve (AUC) of NLR, PTAR, MELD-Na score alone and their combination for predicting the mid-and long-term prognosis of patients with decompensated liver cirrhosis were 0.800 (95%CI: 0.732～0.868), 0.849(95%CI：0.792～0.907), 0.788(95%CI：0.720～0.857) and 0.887(95%CI：0.838～0.937), respectively. The corresponding sensitivities were 80.6%, 76.4%, 72.1% and 88.9%, and the specificities were 72.7%, 81.8%, 74.7% and 71.7%, respectively.
Conclusion NLR, PTAR and MELD-Na score are independent risk factors for the mid-and long-term prognosis of patients with decompensated liver cirrhosis, and the combined predictive efficacy of the three is significantly higher than that of a single detection.

Key words： Decompensated liver cirrhosis; Neutrophil count; Lymphocyte count; Prothrombin time international normalized ratio; Albumin; MELD-Na score

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引用本文

张顺玲, 郑盛, 殷芳, 刘佩, 曾雪丽, 李心怡, NLR、PTAR联合MELD-Na评分对失代偿期肝硬化患者中长期预后的预测价值[J]. 国际临床研究杂志, 2026; 10: (5) : 17-29.

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