Correlation of Simple Laboratory Result Parameters to CTP and MELD Scores, and the Diagnostic Role of Simple Laboratory Indexes to Cirrhosis Decompansation

Ni Nyoman Gita Kharisma Dewi, Ni Luh Putu Yunia Dewi, Putu Itta Sandi Lesmana Dewi, K. M. N. Pamungkas, D. A. Sindhughosa, I. K. Mariadi
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Abstract

BackgroundCirrhosis of the liver is a final condition of all chronic liver diseases. Liver cirrhosis is the leading cause of increasing morbidity and mortality in adults worldwide. Systemic inflammation has been suggested to play an important role in causing progressive liver damage and is one of the leading causes of compensated and decompensated liver cirrhosis.Aim of StudyEvaluate the correlation of neutrophil-lymphocyte ratio (NLR), albumin-bilirubin ratio (ABR), albumin-bilirubin score (ALBI), aspartate aminotransferase to platelet ratio (APRI), albumin-creatinine ratio (ACR), lymphocyte-monocyte ratio (LMR), de ritis ratio to the severity of liver cirrhosis as assessed by CTP score and MELD score. In addition, this study also evaluated the diagnostic ability of NLR, ABR, ALBI, APRI, ACR, LMR, de ritis ratio, and CTP and MELD scores in predicting decompensated liver cirrhosis.MethodWe conducted a cross-sectional study involving patients diagnosed with liver cirrhosis at Prof DR IGNG Ngoerah General Hospital. All patients were diagnosed based on clinical history, physical examination, and investigations. This study enrolled 96 cirrhotic patients regardless of etiology. Laboratory examination results recorded platelets, neutrophils, lymphocytes, monocytes, AST, ALT, albumin, and creatinine. Then NLR, ACR, APRI, LMR, de raitis, ALBI, and ABR are calculated. CTP and MELD scores were calculated by taking data from the patient's medical recordResultOf the 96 patients tested in our study, the majority were male (66). The study found a significant moderate to very strong relationship to the MELD score between ACR, APRI, ALBI, ABR, LMR, WBC, sodium, and albumin. Neutrophil to lymphocyte ratio, ACR, De ritis, APRI, LMR, ALBI, ABR, sodium levels, and albumin have a moderate to very strong significant relationship to CTP score. ACR, De ritis, APRI, LMR, ALBI, ABR, WBC, sodium, and albumin levels with respective cut-offs £ 3.6; ≥ 1.5; ≥ 0.3; £ 2.8; ≥ 0.7; £1.6; ≥ 6.7, £ 136.50, and £ 3.0 can be used to help predict decompensated cirrhosisConclusionIn addition to using the CTP score and MELD score as a tool to predict the severity of liver cirrhosis, data from laboratory examination results in the form of albumin and ABR levels can help establish the diagnosis of decompensated cirrhosis. The sensitivity and specificity of ABR were 96.8% and 75.4% with a cut-off of £  1.6, while albumin levels were 93.5% and 81.5% with an amount off of £  3.0.
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简单实验室结果参数与 CTP 和 MELD 评分的相关性,以及简单实验室指标对肝硬化失代偿期的诊断作用
背景肝硬化是所有慢性肝病的最终病症。肝硬化是全球成人发病率和死亡率不断上升的主要原因。有人认为,全身性炎症在导致肝脏进行性损伤中起着重要作用,是代偿性和失代偿性肝硬化的主要原因之一。研究目的评估中性粒细胞-淋巴细胞比值(NLR)、白蛋白-胆红素比值(ABR)、白蛋白-胆红素评分(ALBI)、天门冬氨酸氨基转移酶与血小板比值(APRI)、白蛋白-肌酐比值(ACR)、淋巴细胞-单核细胞比值(LMR)、de ritis 比值与 CTP 评分和 MELD 评分评估的肝硬化严重程度的相关性。此外,本研究还评估了 NLR、ABR、ALBI、APRI、ACR、LMR、de ritis 比率以及 CTP 和 MELD 评分在预测失代偿期肝硬化方面的诊断能力。所有患者均根据临床病史、体格检查和检查结果确诊。本研究共纳入 96 名肝硬化患者,病因不限。实验室检查结果记录了血小板、中性粒细胞、淋巴细胞、单核细胞、谷草转氨酶(AST)、谷丙转氨酶(ALT)、白蛋白和肌酐。然后计算 NLR、ACR、APRI、LMR、de raitis、ALBI 和 ABR。在我们的研究中,接受检测的 96 名患者中,大多数为男性(66 人)。研究发现,ACR、APRI、ALBI、ABR、LMR、WBC、钠和白蛋白与 MELD 评分之间存在明显的中度到非常强的关系。中性粒细胞与淋巴细胞比值、ACR、De ritis、APRI、LMR、ALBI、ABR、钠水平和白蛋白与 CTP 评分有中度到非常显著的关系。ACR、De ritis、APRI、LMR、ALBI、ABR、白细胞、钠和白蛋白水平的临界值分别为 3.6 英镑;≥ 1.5;≥ 0.3;2.8 英镑;≥ 0.7;1.6 英镑;≥ 6.7、136.50 英镑和 3.0 英镑。结论除了使用 CTP 评分和 MELD 评分作为预测肝硬化严重程度的工具外,白蛋白和 ABR 水平形式的实验室检查结果数据也有助于确定失代偿期肝硬化的诊断。以1.6英镑为临界值,ABR的敏感性和特异性分别为96.8%和75.4%,而以3.0英镑为临界值,白蛋白水平的敏感性和特异性分别为93.5%和81.5%。
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