血小板淋巴细胞比值与中性粒细胞淋巴细胞比值在HBV、HCV感染者中的临床意义评价

Evaluation of the clinical significance of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with HBV or HCV infection

目的:探究血小板淋巴细胞比值(PLR)和中性粒细胞淋巴细胞比值(NLR)在病毒性肝脏疾病进展及预后中临床意义。方法:回顾分析我院电子病历系统数据,依据纳入排除标准,纳入2013年1月至2015年6月来我院就诊的HBV和HCV感染相关肝脏疾病和非病毒性肝脏疾病患者共计309例和健康对照40例(HC组),肝脏疾病患者分为慢性乙型肝炎未治疗(HBV-UT)组、清除(HBV-Cl)组、未清除(HBV-UC)组、肝硬化(HBV-Cirr)组、肝癌(HBV-HCC)组,慢性丙型肝炎未治疗(HCV-UT)组、清除(HCV-Cl)组、未清除(HCV-UC)组、肝硬化(HCV-Cirr)组、肝癌(UV-HCC)组,非病毒性肝炎/肝损伤(UV-Ht)组、肝硬化(UVCirr)组、肝癌(UV-HCC)组,比较各组PLR和NLR差异。结果:HCV-Cl组PLR明显高于HCV-UT、HCV-UC组(P<0.05),HCV-UT、HCV-UC组NLR明显低于HC组(P<0.05)。HCV-UT、HCV-Cirr、HCV-HCC组较之HC组,PLR均显著降低,差异有统计学意义(P<0.05),并且HCV-Cirr、HCV-HCC组较之HCV-UT组PLR也降低,差异有统计学意义(P<0.05),但HCV-Cirr组与HCV-HCC组PLR无差异。结论:PLR和NLR在病毒性肝脏疾病的进展、预后中有着一定的指示作用,尤其HCV感染中,PLR与其病毒学应答和疾病进展密切相关。

Objective： To explore the clinical significance of PLR and NLR in the progression and prognosis ofviral liver disease. Methods： By retrospective analysis of the electronic medical records system data,according to the inclusion and exclusion criteria,a total of 309 patients with liver disease associated with HBV infection,HCV infection or non-viral liver disease were included from January 2013 to June 2015. The group of healthy controls（ HC） consisted of 40 healthy individuals. The patients were divided into HBV untreated（ HBV-UT） group,HBV cleared（ HBV-Cl） group,HBV uncleared（ HBV-UC） group,HBV-cirrhosis（ HBV-Cirr） group,HBV-hepatocellular cancer（ HBV-HCC） group; HCV untreated（ HCV-UT） group,HCV cleared（ HCV-Cl） group,HCV uncleared（ HCV-UC） group,HCV-cirrhosis（ HCV-Cirr） group,HCV-hepatocellular cancer（ UV-HCC） group; Virus-unrelated hepatitis / liver damage（ UV-Ht） group,virus-unrelated cirrhosis（ UV-Cirr） group,virus-unrelated hepatocellular cancer（ UV-HCC） group. The differences of PLR and NLR in each groups were compared. Results： PLR of HCVCl group was obviously higher than that of HCV-UT and HCV-UC group（ P 〈 0. 05）,NLR of HCV-UT and HCVUC group were lower than that of HC group（ P 〈 0. 05）. Compared with HC group,PLR of HCV-UT,HCV-Cirr and HCV-HCC group were significantly lower,and the differences were statistically significant（ P 〈 0. 05）. Compared with HCV-UT,PLR of HCV-Cirr and HCV-HCC group reduce and the differences were statistically significant（ P 〈0. 05）,while PLR of HCV-Cirr and HCV-HCC group showed no difference. Conclusion： PLR and NLR have a certain indicative function in the progression and prognosis of viral liver disease,especially in patients with HCVassociated liver disease.