Effects of platelet to lymphocyte ratio,immunoglobulin,myocardial enzyme spectrum and electrocardiogram parameters on the condition and prognosis of middle-aged and elderly patients with cirrhosis
Objective To explore the predictive value of peripheral blood platelet to lymphocyte ratio(PLR),immunoglobulin,myocardial enzyme spectrum and electrocardiogram parameters for the condition and prognosis of middle-aged and elderly patients with liver cirrhosis.Methods A prospective cohort study method was used to select 83 middle-aged and elderly patients with liver cirrhosis who received treatment in the Jingzhong Medical District of the PLA General Hospital from January 1,2019 to December 30,2020 as the study subjects.According to the Child-Pugh score,they were divided into a compensatory phase group(45 cases)and a decompensated phase group(38 cases).All patients were followed up until December 1,2023,and were divided into a good prognosis group(53 cases)and a poor prognosis group(27 cases)based on their prognosis.PLR,immunoglobulin,myocardial enzyme spectrum and electrocardiogram parameter indicators were compared between different groups.Multiple logistic regression analysis was used to identify risk factors,and a nomogram model was established to predict the condition and prognosis,which was validated and evaluated.Results Compared with the decompensated group of liver cirrhosis,the compensatory group of liver cirrhosis showed statistically significant differences in PLR,IgA,IgG,CK,hs-TnT,prolongation of QT interval on electrocardiogram,conduction block,and arrhythmia(P＜0.05).The logistic regression results indicated that PLR(OR=3.099,95％CI:1.443-7.254),IgG(OR=3.838,95％CI:1.677-7.228),CK(OR=3.149,95％CI:1.847-8.374),and prolonged QT interval(OR=5.894,95％CI:2.276-9.086)were influencing factors of liver cirrhosis(P＜0.05).The prediction model of nomogram showed that the total score ranged from 0 to 180,and the corresponding risk rate ranged from 0.25 to 0.8.The empirical evidence of this model showed that the C-index was 0.729(95％CI:0.682-0.836).The ROC curve results of the nomogram model for predicting liver cirrhosis indicated that the area under the curve was 0.869(95％CI:0.808-0.930),the sensitivity was 80.51％,and the specificity was 74.74％.The differences in PLR,IgA,IgG,IgM,CK,hs-TnT,QT interval prolongation,and Q wave abnormalities among different prognostic groups were statistically significant(P＜0.05).The results of logistic regression analysis indicated that PLR(OR=2.726,95％CI:1.689-5.884),IgA(OR=3.025,95％CI:2.169-6.484),IgG(OR=5.306,95％CI:1.196-9.803),CK(OR=4.632,95％CI:2.217-8.708),and QT interval extension(OR=2.998,95％CI:1.457-5.975)were the influencing factors for the prognosis of liver cirrhosis(P＜0.05).The total score range for establishing a nomogram prediction model was 0-260 points,corresponding to a risk rate range of 0.1-0.9.The C-index of this model was verified to be 0.811(95％CI:0.788-0.892).The ROC curve results of the nomogram model predicting the prognosis of liver cirrhosis indicated that the area under the curve was 0.844(95％CI:0.741-0.939),the sensitivity was 83.02％,and the specificity was 70.37％.Conclusion PLR,IgG,CK,and QT interval prolongation are influencing factors for the condition of middle-aged and elderly patients with liver cirrhosis.PLR,IgA,IgG,CK,and QT interval prolongation are influencing factors for the prognosis of middle-aged and elderly patients with liver cirrhosis.Constructing a nomogram model can help predict the condition and prognosis of liver cirrhosis.
Liver cirrhosisPlatelet to lymphocyte ratioImmunoglobulinMyocardial enzyme spectrumElectrocardiogramMiddle-aged and elderly people
万方数据
维普
