Objective To explore the correlation between neutrophil/lymphocyte ratio(NLR),interferon regulatory factor 1(IRF1),and mechanical ventilation withdrawal failure in patients with acute respiratory failure(ARF).Methods From Sep-tember 2022 to September 2023,a prospective study was conducted on 120 critically severe ARF patients admitted to our hospital.According to the outcome of invasive mechanical ventilation withdrawal,patients were divided into withdrawal failure group and withdrawal success group.NLR and IRF1 before ventilation,24 hours after ventilation and 48 hours after ventilation were com-pared.The correlation between NLR and IRF1 and the failure of mechanical ventilation was analyzed,and the value of two indexes in predicting the failure of mechanical ventilation was evaluated.Results After evaluation,28 patients failed to withdraw,account-ing for 23.33％.The proportion of invasive mechanical ventilation time≥7days in the withdrawal failure group was higher than that in the withdrawal success group(P＜0.05).The mRNA of NLR and IRF1 in the withdrawal failure group before ventilation,24 hours after ventilation,and 48 hours after ventilation were higher than those in the withdrawal success group(P＜0.05).And two indicators at each time point were positively correlated with mechanical ventilation withdrawal failure in ARF patients(r＞0,P＜0.05),with the highest r value at 48 hours after ventilation.The correlation between NLR,IRF1,and mechanical ventilation withdrawal failure was analyzed using a restricted cubic spline model(RCS)using 48 hours of ventilation data,and showed a non-linear J-shaped dose-response relationship.Logistic regression analysis showed that NLR,IRF1,and invasive mechanical venti-lation time ≥7 days after 48 hours of ventilation were all related factors affecting mechanical ventilation withdrawal failure in ARF patients(P＜0.05).Patients were divided into low-risk and high-risk groups based on the optimal cutoff value of the regression e-quation.The incidence of related complications during the first withdrawal period in the high-risk group was higher than that in the low-risk group(P＜0.05).The receiver operating characteristic curve(ROC)showed that the area under the curve of NLR,IRF1 alone and combined prediction of mechanical ventilation weaning failure in ARF patients at 48 h of ventilation was 0.776,0.937 and 0.952,respectively,which had certain predictive value,and the combined prediction efficiency was relatively high.Conclusion NLR and IRF1 are closely related to the failure of mechanical ventilation weaning in ARF patients.The mechanism is mainly related to inflammatory response.At the same time,the two indicators have a certain auxiliary role in suggesting changes in the patient's condition,and NLR and IRF1 have certain value in predicting the failure of mechanical ventilation weaning in ARF patients.
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