肝移植术后外周血中性粒细胞/淋巴细胞比值与T细胞介导排斥反应的相关性分析

doi:10.3969/j.issn.1001-8131.2025.06.002

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摘要目的探究肝移植术后外周血中性粒细胞/淋巴细胞比值与T细胞介导排斥反应（TCMR）的相关性。方法本研究收集80例肝移植病例,分析肝移植术后的急性排斥反应与NLR之间的关系。以术后是否出现排斥反应分为排斥组16例,非排斥组64例,对比两组术前、术中及术后的临床信息;通过Log Rank检验患者出现排斥反应的风险程度;Logstic回归单因素、多因素分析患者肝移植术后出现TCMR的危险因素;Pearson相关性分析。结果排斥组术后出现急性排斥反应的受者手术时长、RAI、术后NLR值均较高;排斥组RAI水平更高;以患者术后14d是否发生急性排斥反应为因变量（发生=1,不发生=0）,Logstic因素分析发现RAI、术后第3天NLR、术后第5天NLR、手术时长、输红细胞量是肝移植术后出现TCMR的危险因素。且独立危险因素中,术后第1天NLR的影响最显著。且Pearson相关性显示呈正相关。结论肝移植手术时间越长,输血量、术后RAI及NLR越高的受者出现急性排斥反应的风险性越高,临床需予以关注和临床预防。

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	孙一博
	赵云峰
	苗书斋

关键词 ：肝移植术后, 外周血中性粒细胞/淋巴细胞比值, T细胞介导排斥反应, 相关性

Abstract：Objective To investigate the correlation between neutrophil/lymphocyte ratio in peripheral blood and T cell mediated rejection after liver transplantation. Methods This study enrolled 80 liver transplant recipients.Patients were divided into a rejection group(16 cases)and a non-rejection group(64 cases)based on the occurrence of TCMR.Preoperative,intraoperative,and postoperative clinical data were compared between the two groups.Risk factors for TCMR were analyzed using the Log-rank test and Logistic regression(univariate and multivariate analyses).Pearson correlation was used to assess associations. Results The rejection group exhibited significantly longer operative time,higher Rejection Activity Index(RAI),and elevated postoperative NLR levels.Multivariate Logistic regression identified RAI,NLR on postoperative day 3,NLR on day 5,operative duration,and red blood cell transfusion volume as independent risk factors for TCMR(Figure 2).Among these,NLR on day 1 showed the strongest association.Pearson correlation confirmed a positive correlation between these factors and TCMR risk. Conclusion Prolonged operative time,increased red blood cell transfusion volume,elevated postoperative RAI,and higher NLR values are associated with an increased risk of acute rejection after liver transplantation.These findings highlight the need for clinical monitoring and preventive strategies.

Key words： Liver transplantation Neutrophil-to-lymphocyte ratio(NLR) T cell mediated rejection Correlation

收稿日期: 2025-07-22

PACS:

R657.3

基金资助:郑州市医疗卫生领域科技创新指导计划项目（2024YLZDJH300）

引用本文:

孙一博, 赵云峰, 苗书斋. 肝移植术后外周血中性粒细胞/淋巴细胞比值与T细胞介导排斥反应的相关性分析[J]. 哈尔滨医药, 2025, 45(6): 5-9.
Sun Yibo, Zhao Yunfeng, Miao Shuzhai. Correlation Analysis between Neutrophil/lymphocyte Ratio in Peripheral Blood and T cell Mediated Rejection after Liver Transplantation. journal1, 2025, 45(6): 5-9.

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