Role Of Peripheral Blood Neutrophil-lymphocyte Ratio In Disease Progression Of Patients With Hepatitis B Virus Infection

Objective Neutrophil-to-lymphocyte ratio(NLR)is a novel inflammation marker that can be used to predict clinical outcomes independently.Inflammatory response plays an important role in the process of exacerbation of hepatitis B virus infection.In this article,We aimed to investigate the predictive value of NLR in the disease progression.Methods 60 normal healthy persons(control group,group A),111 cases with severe chronic hepatitis B(group B),92 cases with decompensation liver cirrhosis(group C),86 cases with acute-on-chronic liver failure(group D)were enrolled in this study.A blood sample was collected for all subjects at admission to examine blood routine,liver function,blood coagulation function,and NLRs were calculated.According to disease progression,group B was divided into group B1(16 cases,progressed to ACLF)and group B2(95 cases,who didn't progressed to ACLF).By comparing the difference of the NLR values between groups,we evaluated the prognostic value of the NLR.Statistical analyses were performed using the statistical package SPSS version 20.0 and the level of statistical significance was set at p < 0.05.Result(1)A,B,C,D group NLR values were 2.22(1.76,3.05),2.54(1.78,3.49),3.07(1.95,5.04),3.41(2.01,5.15)respectively.NLR was increased with the deterioration of the illness.(2)In group B,16 cases were progressed to ACLF(group B1),the others were still severe chronic hepatitis B(group B2).Univariate and multivariate analysis showed that NLR and PTA were significant prognostic factors for disease progression.Moreover there was significant difference of NLR between group B1 and group B2(3.97±1.54VS2.71±1.54,P=0.004).When the 16 patients with severe chronic hepatitis B progressed to ACLF,NLR were increased significantly(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the cut-off value of 2.79 for NLR predicted disease progression in severe chronic hepatitis B patients(AUC:0.739,P=0.002)(3)ROC curve analysis showed that the cut-off value of 3.94 for NLR predicted end-stage liver disease(AUC:0.612,P=0.001).(4)Correlation analysis showed that NLR was significantly negative correlated with ALB,PTA,and positive correlated with TBil.Conclusion NLR in the peripheral blood of patients with hepatitis B virus infection can reflect disease progression and predict the occurrence of liver failure.