Short-term Prognostic Value Of NLR,Serum Procalcitonin And MELD Model In Patients With Aute-on-chronic (Subacute) Liver Failure

Objective:1.To explore the short-term(3 months)prognostic value of the rate of the Neutrophils and Lymphocytes(NLR),serum procalcitonin(PCT)and MELD model in the survival group and the dead group with aute-on-chronic(subacute)liver failure;2.To explore the short-term(3 months)prognostic value of the rate of the neutrophils and Lymphocytes(NLR),serum procalcitonin(PCT)and MELD model in the infection group and the disinfection group with aute-on-chronic(subacute)liver failure.Methods:A total of 68 patients with aute on-chronic(subacute)liver failure were divided into survival group and dead group.and with or without infection group.The hepatic biological Indics(ALT,AST,ALP,GGT,TBIL),blood routine,PCT,CRP,and blood coagulation were recorded in patients with liver failures normal health 33;examinations were collected as control group,and the hepatic biological Indics,blood routine,PCT and,blood coagulation were recorded.The NLR and MELD were calculated.Using SPSS 17 software for statistical analysis.Count data by chi-Asquare test,P<0.05 for statiatical significance using Pearson correlation analysis for;the correlation analysis;using the ROC and the area under the curve to evaluate the veracity of the index to the prognosis of theaute-on-chronic(subacute)liver failur the NLR,CRP,PCT and MELD were included in a multivariate logistic regression analysis in order to indentify the indepeddent predictors of the aute-on-chronic(subacute)liver failure.Results:1.The age and gender were respectively 0.413 and 0.387 and,the P>0.05,there was no statistical difference between the liver failure group and the control group,but the value of the NLR,CRP PCT,were 1.91 + 0.75,5.85 + 4.66;5.58 + 2.47,19.73 +15.78;0.17 + 0.11,1.89 + 2.11 the score of P were,0,0,0.003,remaining statistically significant.2.The contrast of the age,gender,NLR,PCT,CRP,MELD between the survival group and dead group: The age and gender were respectively 0.097 and 0.851,and the P>0.05,there was no statistical difference but the value of the;NLR,CRP,PCT,were4.61 + 4.07,7.46 + 11.65,17.89 + 4.88;21.58 + 7.50;0.78 + 0.61,1.63 + 3.15;11.97+ 2.45,14.22 + 3.93,the score of P were0.012,0.065,0.007,0.036,remaining statistically significant.3.The contrast of the age,gender,NLR,PCT,CRP,MELD between the infection group and non-infected ones: The age and gender were respectively0.432,0.214,and the P>0.05,there was no statistical difference but the value of the;NLR,CRP,PCT were8.89 + 7.23,4.44 + 2.69;22.76 + 15.35,12.79 + 8.36;2.21 + 2.59,0.60 + 0.34;14.01 + 3.64,11.97 + 2.42,the score of P were0.002,0.003,0.001,0.004,remaining statistically significant.4 The contrast of the survival rate between the infection group and non-infected group: By the data analysis,the P value of the survival rate was 0.007 there was statistical difference,between the infection group and non-infected group,reminding that the infection can affect the prognosis in liver failure.5 The correlation study of the NLR and PCT: By the Pearson analysis,the correlation index of the NLR and PCT respectively were between the patients 0.275 and 0.361 with liver failure with the admission and the infection.6 The value of the NLR,PCT MELD,to the aute-on-chronic(subacute)liver failure with infection: By portraying the ROC,the area under the curve respectively were 0.747,0.573,0.694,reminding that when patients were infected,the NLR,PCT and MELD could affect prognosis.The value of cut off respectively :NLR was equaled to 4.81(sensitivity77.3% and specificity65.1%);the PCT was equaled to0.82(sensitivity49% and specificity79%);the MELD was equaled to12.85(sensitivity71.1% and specificity68.5%)7 Establishment of the prediction model with the NLR,PCT MELD,using the multivariable logistic regression analysis in aute-on-chronic(subacute)liver failure on admission: By analysis,the score of P to the NLR,PCT MELD,were respectively0,0,0.791,reminding that the higher NLR,MELD on admission,the higher death rate.Conclusion:The NLR,PCT are both increased in patients with liver failure and in infection group significantly.The NLR,MELD score on admission are independent risk factors for hepatic failure survival.