Application of neutrophil-lymphocyte ratio on early diagnosis and curative effect in cirrhosis patients with ascites infection

Objective To explore the significance of neutrophillymphocyte ratio (NLR) to early diagnosis and curative effect in hepatitis B cirrhosis patients with ascites infection. Methods The white blood cell count (WBC) , NLR, high-sensitive C reactive protein (HS-CRP) and procalcitonin (PCT) of 232 hepatitis B cirrhosis patients (51 cases of compensatory phase cirrhosis patients, 109 cases of cirrhosis patients with ascites infection and 72 cases of cirrhosis patients without ascites infection) and 58 healthy persons (control group) were analyzed retrospectively. The changes of patients with ascites infection were observed before and after treatment. The diagnostic tests and ROC curve were used to compare the diagnostic value of the indexes. Results The differences among the levels of NLR, HS-CRP, PCT and WBC in 4 groups were statistically significant (F=7.31, 11.21, 17.22 and 6.88, P all<0.05). The ascites infection patients were higher than other 3 groups (q=4.11-11.85, P<0.01). The sensitivity, specificity, positive predictive values and negative predictive values of NLR were all close to those of PCT and HS-CRP. The area under ROC curve of NLR [0.923, 95%CI (0.893-0.975)] was higher than that of PCT, HS-CRP and WBC (0.891, 0.855 and 0.684) , respectively. The cut-off value of NLR was 2.38, while sensitivity and specificity were 93.57% and 73.41%, respectively. After 3 and 7 days of treatment, the the average NLR levels of patients with negative bacterial culture were lower than the cut-off value, the ranges were (1.97-2.37) and (1.89-2.35). However, the average PCT, HS-CRP and WBC levels were all higher than the respective cutoff values. Conclusions NLR may be a sensitive and practical parameter on early diagnosis and curative effect for ascites infection in hepatitis B cirrhosis patients. Key words: Liver cirrhosis; Ascites infection; Neutrophillymphocyte ratio; Early diagnosis; Therapeutic evaluation