Abstract:

Objective To investigate the prognostic value of Neutrophil⁃lymphocyte ratio（NLR）and its dynamic changes in the treatment of hepatitis B associated acute⁃on⁃chronic liver failure（HBV⁃ACLF）with artifi⁃ cial liver. Methods Patients were selected from the Department of Gastroenterology，Western Theater Command General Hospital from January 2018 to December 2021，and received artificial liver support System. Clinical data and relevant laboratory data were retrospectively collected. Patients were divided into survival group and death group according to 90⁃ day disease outcome. Differences between groups were compared to analyze the evaluation value of NLR and its dynamic change level on patients' prognosis. Results A total of 106 patients，male 88 cases， （83.02%）and female 18 cases（16.98%），with a median age of 48 years（41.75，56），were enrolled in this study. Binary logistic regression showed that NLR was an independent risk factor for death of HBV ⁃ACLF patients after ALSS（P < 0.05），the level of NLR in survival group［3.94（2.90 ~ 5.47）］was significantly lower than that in death group［5.35（4.12 ~ 7.59），P < 0.05］Baseline NLR level was positively correlated with MELD score，MELD⁃Na score，and iMELD score（P < 0.05）The area under ROC curve to determine the 90⁃day mortality rate of HBV ⁃ ACLF patients by NLR level 1 day before and 3 days after the baseline was 0.72，0.712，0.72，respectively. Survival analysis showed that the 90⁃day survival rate in the low NLR group was significantly higher than that in the high NLR group（P < 0.05）. NLR change rate（ΔNLR）was significantly different between survival and death groups. Conclusion Serum NLR level can be used as a potential prognostic indicator for patients with acute⁃on⁃chronic liver failure treated with artificial liver therapy，and dynamic monitoring has higher clinical value. 

Key words: neutrophil ?lymphocyte ratio； , hepatitis B virus associated acute ? on ? chronic liver failure； , artificial liver； , dynamic change