慢性乙型肝炎患者红细胞容积分布宽度与肝纤维化程度的相关性研究

The relation between red blood cell volume distribution width and degree of liver fibrosis in patients with chronic hepatitis B

目的：探讨慢性乙型肝炎（CHB）患者的红细胞容积分布宽度（RDW）与肝纤维化严重程度的相关性。方法连续性选择CHB患者164例，根据基于4项因素肝纤维化指数模型（FIB-4）指数分为低值组（FIB-4＜1.45，116例）、中值组（FIB-41.45~3.25，31例）及高值组（FIB-4＞3.25，17例），比较各临床资料及实验室指标；再根据 RDW 的四分位数将患者分为Ⅰ组（RDW＜0.113，43例）、Ⅱ组（RDW 0.113~0.119，40例）、Ⅲ组（RDW 0.120~0.127，43例）、Ⅳ组（RDW＞0.127，38例），比较FIB-4；采用Spearman法对RDW与FIB-4进行相关分析。结果低值组、中值组、高值组RDW和天冬氨酸氨基转移酶（AST）逐渐升高[0.117±0.011、0.122±0.010、0.134±0.018和（18.9±7.3）、（28.2±10.4）、（44.1±13.3）U/L]，而血小板逐渐降低[（211.3±48.8）、（159.3±40.0）、（150.4±31.2）×109/L]，差异有统计学意义（P＜0.05）。Ⅰ组、Ⅱ组、Ⅲ组、Ⅳ组FIB-4逐渐增高（1.07±0.74、1.11±0.56、1.35±0.70、2.03±1.06），差异有统计学意义（P＜0.05）。Spearman相关分析结果显示，FIB-4与RDW呈显著正相关（r=0.447，P＜0.01）。结论 CHB患者随着FIB-4升高RDW也随着增加，RDW与纤维化严重程度密切相关，RDW可能对肝纤维化的进程有潜在的评估价值。

Objective To explore the relationship between red blood cell volume distribution width （RDW） and degree of liver fibrosis in patients with chronic hepatitis B （CHB）. Methods One hundred and sixty-four patients with CHB were consecutively selected. According to the fibrosis index based on the 4 factors （FIB-4） index, the patients were divided into 3 groups： low-FIB group （FIB-4 〈1.45, 116 cases）, mid-FIB group （FIB-4 1.45-3.25, 31 cases） and high-FIB group （FIB-4 〉 3.25, 17 cases）, and the clinical data and laboratory indexes （including RDW） were compared. The patients were divided into Ⅰ group （RDW〈0.113, 43 cases）, Ⅱ groups （RDW 0.113-0.119, 40 cases）, Ⅲ group （RDW 0.120-0.127, 43 cases） andⅣgroup （RDW〉0.127, 38 cases） according to the RDW, and the FIB-4 were compared. The correlation between RDW and FIB-4 was analyzed by Spearman correlation test. Results The RDW and aspartate aminotransferase （AST） in low-FIB group, mid-FIB group and high- FIB group were gradually increased： 0.117 ± 0.011, 0.122 ± 0.010, 0.134 ± 0.018 and （18.9 ± 7.3）, （28.2 ± 10.4）, （44.1 ± 13.3） U/L, but the platelet was gradually decreased：（211.3 ± 48.8）, （159.3 ± 40.0） and （150.4 ± 31.2） ×109/L, and there were statistical differences （P〈0.05）. The FIB-4 inⅠgroup,Ⅱgroup,Ⅲgroup andⅣgroup was gradually increased：1.07 ± 0.74, 1.11 ± 0.56, 1.35 ± 0.70 and 2.03 ± 1.06, and there was statistical difference （P〈0.05）. Spearman correlation test result showed that FIB-4 and RDW was positively correlated （r=0.447, P〈0.01）. Conclusions The level of RDW is closely related with the degree of liver fibrosis in patients with CHB. RDW has a potential value in＆nbsp;assessing the progress of liver fibrosis.