Neutrophil-to-lymphocyte ratio (NLR) as a predictive index for liver and coagulation dysfunction in preeclampsia patients.
Neutrophil-to-lymphocyte ratio (NLR) as a predictive index for liver and coagulation dysfunction in preeclampsia patients.
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中性粒细胞与淋巴细胞比值（NLR）作为子痫前期患者肝脏和凝血功能障碍的预测指标
DOI：
10.1186/s12884-022-05335-1
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发表时间：
2023-01-04
影响因子：
3.1
通讯作者：
中科院分区：
文献类型：
--
作者：
背景先兆子痫（PE）是一种与免疫反应增强有关的妊娠疾病。已知中性粒细胞或单核细胞与淋巴细胞比率（NLR、MLR）等免疫细胞特征与高血压患者的肾和肝功能障碍有关。本研究旨在分析NLR、MLR和血小板与淋巴细胞比值（PLR）与肝、肾和凝血功能参数之间的相关性以及这些免疫细胞谱对PE患者预后意义的影响。方法对2016年至2019年在延边大学医院产科登记的320例首次妊娠妇女的产前血液学和生化参数进行回顾性分析。根据诊断标准将患者分为正常妊娠组（正常，n=≥161）、轻度PE（mPE，n=≥28）和重度PE（sPE，n=≥131）组。对NLR、MLR和PLR的诊断价值进行Pearson相关分析和曲线下面积（AUC）。结果通过首尔国立大学医院 (SNUH) 妇产科的数据进行了验证。结果与正常组相比，mPE 和 sPE 的肾功能指标较差，sPE 的肝脏和凝血指标较差。免疫细胞中，mPE和sPE患者淋巴细胞增多，导致PE组NLR、MLR和PLR降低，sPE差异更显着。在 sPE 中，NLR 和 PLR 与 CREA 和/或 BUN 呈负相关，而与总蛋白 (TP) 和白蛋白 (ALB) 呈正相关。在 sPE 中，只有 NLR 与凝血指数（PT 和 APTT）呈正相关。 NLR、MLR 和 PLR 的 AUC 分析分别为 0.700、0.656、0.643，NLR < 3.7 预测高血压（所有参与者的 95% CI：0.647–0.749，p< 0.001）。血压、肝脏、肾脏和凝血指标在临界值时较差(NLR < 3.7)，这得到了首尔国立大学医院数据的验证。结论NLR可以作为PE患者肝脏和凝血功能障碍的独立预测因子。我们的结果可能为PE患者的风险评估提供非侵入性且有效的方法。
BackgroundPre-eclampsia (PE) is a pregnancy disorder that is related to an enhanced immune response. Immune cell characteristics such as neutrophil or monocyte to lymphocyte ratios (NLR, MLR) are known to be related to kidney and liver dysfunction in hypertensive patients. Here, we aimed to analyze the correlations between NLR, MLR and platelet to lymphocyte ratio (PLR) and liver, renal and coagulation functional parameters and the impacts of these immune cell profiles to the prognostic significance in PE patients.MethodsPre-delivery hematological and biochemical parameters of 320 first-time pregnant women registered at the Obstetrics Department of Yanbian University Hospital from 2016 to 2019 were analyzed retrospectively. Patients were divided into normal pregnancy (normal,n= 161), mild PE (mPE,n= 28) and severe PE (sPE,n= 131) groups according to diagnostic criteria. Pearson correlation analysis were performed and area under the curve (AUC) were conducted for the diagnostic values of NLR, MLR and PLR. Results were validated with data from the Department of Obstetrics and Gynecology of Seoul National University Hospital (SNUH).ResultsKidney functional indexes were adversative in mPE and sPE and liver and coagulation indexes were worse in sPE compared to normal groups. Among immune cells, lymphocytes were increased in mPE and sPE patients, resulted in reduced NLR, MLR and PLR in PE groups, more significant difference were shown in sPE. NLR and PLR were associated with CREA and/or BUN negatively and positive associations were observed with total protein (TP) and albumin (ALB) in sPE. Only NLR showed positive associations with coagulation indexes (PT and APTT) in sPE. AUC analysis for NLR, MLR and PLR were 0.700, 0.656, 0.643, respectively, and NLR < 3.7 predicted hypertension (95% CI in all participants: 0.647–0.749,p< 0.001). Blood pressure, liver, kidney and coagulation indexes were worse at cut off value (NLR < 3.7), and this was validated with the data from SNUH.ConclusionNLR could be used as an independent predictor of liver and coagulation dysfunction in PE patients. Our results may provide non-invasive and efficient way of the risk assessment among PE patients.
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影响因子：
4.6
作者：
Morisaki N;Piedvache A;Nagata C;Michikawa T;Morokuma S;Kato K;Sanefuji M;Shibata E;Tsuji M;Shimono M;Ohga S;Kusuhara K;Japan Environment and Children’s Study Group
通讯作者：
Japan Environment and Children’s Study Group
影响因子：
12.3
作者：
Elgari, Mahmoud M.;Khabour, Omar F.;Alhag, Samaher M.
通讯作者：
Alhag, Samaher M.
影响因子：
3.8
作者：
Ji F;Liang Y;Fu SJ;Guo ZY;Shu M;Shen SL;Li SQ;Peng BG;Liang LJ;Hua YP
通讯作者：
Hua YP
影响因子：
7.3
作者：
Faas MM;Spaans F;De Vos P
通讯作者：
De Vos P
影响因子：
1.3
作者：
Gezer, Cenk;Ekin, Atalay;Taner, Cuneyt Eftal
通讯作者：
Taner, Cuneyt Eftal