红细胞分布宽度、平均血小板体积及中性粒细胞-淋巴细胞比值在原发性胆汁性胆管炎中的评估价值

杨柳; 陈向金; 李变利; 彭颖; 徐丽红

doi:10.3969/j.issn.1001-5256.2019.12.026

红细胞分布宽度、平均血小板体积及中性粒细胞-淋巴细胞比值在原发性胆汁性胆管炎中的评估价值

DOI: 10.3969/j.issn.1001-5256.2019.12.026

1. 石河子大学医学院
2. 成都市第五人民医院消化内科
3. 石河子大学第一附属医院消化内科

基金项目:

国家自然科学基金(81360076)；

详细信息

中图分类号: R575.7
计量
- 文章访问数: 1142
- HTML全文浏览量: 38
- PDF下载量: 239
- 被引次数: 0
出版历程
- 收稿日期: 2019-07-01
- 出版日期: 2019-12-20

Value of red blood cell distribution width,mean platelet volume,and neutrophil-lymphocyte ratio in the evaluation of primary biliary cholangitis

Medical College of Shihezi University

Research funding:

摘要

摘要:
目的分析红细胞分布宽度（RDW）、平均血小板体积（MPV）、血小板分布宽度（PDW）、淋巴细胞-单核细胞比值（LMR）、血小板-淋巴细胞比值（PLR）及中性粒细胞-淋巴细胞比值（NLR）在原发性胆汁性胆管炎（PBC）患者病情恶化进展中的评估价值。方法回顾性分析2015年12月-2019年3月于石河子大学第一附属医院明确诊断为PBC的80例患者的肝功能及血常规检测中的RDW、MPV、PDW指标,并计算NLR、LMR、PLR。根据诊断标准分为PBC肝硬化组（n=50）和PBC肝炎组（n=30）。符合正态分布的计量资料两组间比较采用独立样本t检验;非正态分布的计量资料两组间比较采用Mann-Whitney U检验。计数资料组间比较采用χ2检验。通过二元logistic回归分析影响PBC肝硬化的危险因素。绘制受试者工作特征（ROC）曲线,比较不同指标对PBC肝硬化的诊断价值。结果较PBC肝炎组,PBC肝硬化组的血清WBC水平明显降低（Z=-4. 777,P<0. 001）,而血清ALT水平明显下降（Z=-2. 152,P=0. 031）。与PBC肝炎组相比,PBC肝硬化组的RDW、MP...
- 胆管炎,硬化性 /
- 红细胞分布宽度 /
- 平均血小板体积 /
- 中性粒细胞-淋巴细胞比值
Abstract:
Objective To investigate the value of red blood cell distribution width( RDW),mean platelet volume( MPV),platelet distribution width( PDW),lymphocyte-monocyte ratio( LMR),platelet-lymphocyte ratio( PLR),and neutrophil-lymphocyte ratio( NLR)in evaluating the deterioration and progression of primary biliary cholangitis( PBC). Methods A retrospective analysis was performed for the clinical data of 80 patients who were diagnosed with PBC in The First Affiliated Hospital of Shihezi University from December 2015 to March 2019,including liver function and RDW,MPV,and PDW in routine blood test,and NLR,LMR,and PLR were calculated. According to related diagnostic criteria,the patients were divided into PBC liver cirrhosis group and PBC hepatitis group. The independent samples t-test was used for comparison of normally distributed continuous data between groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. The chi-square test was used for comparison of categorical data between groups. A binary logistic regression analysis was used to investigate the risk factors for PBC liver cirrhosis. The receiver operating characteristic( ROC) curve was plotted to compare the value of different indices in the diagnosis of PBC liver cirrhosis. Results Compared with the PBC hepatitis group,the PBC liver cirrhosis group had a significant reduction in the serum level of white blood cells( Z =-4. 777,P<0. 001) and a significant reduction in the serum level of alanine aminotransferase( Z =-2. 152,P = 0. 031). Compared with the PBC hepatitis group,the PBC liver cirrhosis group had significant increases in RDW,MPV,and NLR( Z =-3. 180,-2. 963,and-3. 590,all P< 0. 05). The binary logistic regression analysis showed that RDW( odds ratio [OR] = 4. 99,95% confidence interval [CI]: 1. 39-17. 92),MPV( OR = 13. 01,95% CI: 2. 96-57. 07),and NLR( OR = 4. 45,95% CI: 1. 59-12. 40) were independent risk factors for progression to liver cirrhosis in PBC patients,for the diagnosis of which RDW,MPV,and NLR had an area under the ROC curve of 0. 683,0. 667,and 0. 741,respectively,while the combination of these three indices had an area under the ROC curve of 0. 891. Conclusion In-creases in RDW,MPV,and NLR may indicate the progression to liver cirrhosis in PBC patients and thus have a certain value in predicting malignant progression in PBC patients.
- cholangitis,sclerosing /
- red blood cell /
- mean platelet volume /
- neutrophil-lymphocyte ratio

HTML全文

参考文献(17)

[1] BEUERS U,GERSHWIN ME,GISH RG,et al. Changing nomenclature for PBC:From ‘cirrhosis’to ‘cholangitis’[J].Hepatology,2015,62(5):1620-1622.

[2] WANG LF,LI YY,JIN L,et al. Epidemiology and natural history of primary biliary cirrhosis[J]. J Clin Hepatol,2015,31(2):165-170.(in Chinese)王立峰，李元元，金磊，等．原发性胆汁性肝硬化的流行病学与自然史变迁[J]．临床肝胆病杂志，2015,31(2):165-170.

[3] KOYAMA Y,BRENNER DA. Liver inflammation and fibrosis[J]. J Clin Invest,2017,127(1):55-64.

[4] SYLMAN JL,MITRUGNO A,ATALLAH M,et al. The predictive value of inflammation-related peripheral blood measurements in cancer staging and prognosis[J]. Front Oncol,2018,8:78.

[5] FENG GH,LI HP,LI QL,et al. Red blood cell distribution width and ischaemic stroke[J]. Stroke Vasc Neurol,2017,2(3):172-175.

[6] SEROPIAN IM,ROMEO FJ,PIZARRO R,et al. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as predictors of survival after heart transplantation[J]. ESC Heart Failure,2018,5(1):149-156.

[7] Chinese Society of Hepatology,Chinese Medical Association;Chinese Society of Gastroenterology,Chinese Medical Association; Chinese Society of Infectious Diseases,Chinese Medical Association. Consensus on the diagnosis and management of primary biliary cirrhosis(cholangitis)(2015)[J]. J Clin Hepatol,2015,31(12):1980-1988.(in Chinese)中华医学会肝病学分会，中华医学会消化病学分会，中华医学会感染病学分会．原发性胆汁性肝硬化(又名原发性胆汁性胆管炎)诊断和治疗共识(2015)[J]．临床肝胆病杂志，2015,31(12):1980-1988.

[8] Chinese Society of Infectious Diseases and Parasitology,Chinese Society of Hepatology, Chinese Medical Association.Prevention and treatment of viral hepatitis[J]. Chin J Intern Med,2001,40(1):62-68.(in Chinese)中华医学会传染病与寄生虫病学分会、肝病学分会．病毒性肝炎防治方案[J]．中华内科杂志，2001,40(1):62-68.

[9] WANG L,HAN Y. An excerpt of primary biliary cholangitis:2018 practice guidance from the American Association for the Study of Liver Diseases[J]. J Clin Hepatol,2018,34(11):2300-2304.(in Chinese)王璐，韩英．《2018年美国肝病学会原发性胆汁性胆管炎实践指导》摘译[J]．临床肝胆病杂志，2018,34(11):2300-2304.

[10] MAYO MJ. Natural history of primary biliary cirrhosis[J]. Clin Liver Dis,2008,12(2):277-288.

[11] CHEUNG K,SETO W,FUNG J,et al. Epidemiology and natural history of primary biliary cholangitis in the Chinese:A territory-based study in Hong Kong between 2000 and 2015[J].Clin Transl Gastroenterol,2017,8(8):e116.

[12] ZHANG LN,SHI TY,SHI XH,et al. Early biochemical response to ursodeoxycholic acid and long-term prognosis of primary biliary cirrhosis:Results of a 14-year cohort study[J]. Hepatology,2013,58(1):264-272.

[13] PAN Y,MUHEREMU A,WU X,et al. Relationship between platelet parameters and hepatic pathology in patients with chronic hepatitis B infection–a retrospective cohort study of677 patients[J]. J Int Med Res,2016,44(4):779-786.

[14] PENG Y,LI Y,HE Y. The role of neutrophil to lymphocyte ratio for the assessment of liver fibrosis and cirrhosis:A systematic review[J]. Expert Rev Gastroenterol Hepatol,2018,12(5):503-513.

[15] TAHTACI M,YUREKLI OT,BOLAT AD,et al. Increased mean platelet volume is related to histologic severity of primary biliary cirrhosis[J]. Eur J Gastroenterol Hepatol,2015,27(12):1382-1385.

[16] HU Z,SUN Y,WANG Q,et al. Red blood cell distribution width is a potential prognostic index for liver disease[J]. Clin Chem Lab Med,2013,51(7):1403-1408.

[17] KIM WR,FLAMM SL,di BISCEGLIE AM,et al. Serum activity of alanine aminotransferase(alt)as an indicator of health and disease[J]. Hepatology,2008,47(4):1363-1370.

施引文献

资源附件(0)

访问统计