中性粒细胞单核细胞比值在非酒精性脂肪性肝病诊断中价值.docVIP

中性粒细胞单核细胞比值在非酒精性脂肪性肝病诊断中的价值 　　【摘要】 目的 研究中性粒细胞淋巴细胞比值（NLR）是否可作为非酒精性脂肪性肝病（NAFLD）临床诊断及监测的有效指标。方法 选取107例临床明确诊断为NAFLD且未经过药物治疗的患者作为病例组， 同时选取106例年龄及性别匹配的健康受试者作为对照组。检测外周血血常规并计算NLR。结果 病例组体质量指数（BMI）为（25.99±3.35）kg/m2， 高于对照组的（22.47±2.33）kg/m2， 差异有统计学意义（P0.05）。病例组外周血谷丙转氨酶（ALT）、白细胞（WBC）计数、中性粒细胞（N）计数、NLR平均值及标准差分别为（48.37±27.84）U/L、（6.09±1.42）×109/L、（3.47±1.06）×109/L、（1.84±0.68）， 显著高于对照组（29.57±18.61）U/L、（5.64±1.30）×109/L、（3.09±0.96）×109/L、（1.63±0.66）， 差异有统计学意义（P=0.000、0.046、0.007、0.0050.05）。NLR的曲线下的面积为0.791， 相应的95%置信区间0.706， 0.876， 当cutoff值取1.63时， 敏感性为79.6%， 特异性为69%。结论 NLR可能用于NAFLD患者诊断及肝功能损害预测， 具有较高的特异性及敏感性。 　　【关键词】 非酒精性脂肪性肝病；中性粒细胞淋巴细胞比值；诊断 　　DOI：10.14163/j.cnki.11-5547/r.2016.31.015 　　【Abstract】 Objective To research whether neutrophil to lymphocyte ratio （NLR） can be an effective index in clinical diagnosis and monitoring of non-alcoholic fatty liver disease （NAFLD）. Methods There were 107 patients with diagnosed NAFLD and no drug therapy as medical case group and another 106 healthy people as control group. Their peripheral blood routine was detected to calculate NLR. Results The medical case group had higher body mass index （BMI） as （25.99±3.35） kg/m2 than （22.47±2.33） kg/m2 of the control group， and the difference had statistical significance （P0.05）. The medical case group had peripheral blood alanine transaminase （ALT）， white blood cell （WBC） count， neutrophil （N） count， NLR mean value and standard deviation as （48.37±27.84） U/L， （6.09±1.42）×109/L， （3.47±1.06）×109/L and （1.84±0.68）， which were all higher than （29.57±18.61） U/L， （5.64±1.30）×109/L， （3.09±0.96）×109/L， （1.63±0.66） in the control group， and their difference had statistical significance （P=0.000， 0.046， 0.007， 0.0050.05）. NLR had area under curve as 0.791 and 95% confidence interval as 0.706， 0.876. Its sensibility was 79.6% and specificity was 69% with cutoff value as 1.63. Conclusions NLR can be applied to diagnose NAFLD and predict liver function damage， along with high specificity and sensibility. 　　【Key