血小板和淋巴细胞比率与丙型肝炎及丙肝肝硬化关系研究

The platelet to lymphocyte ratio( PLR) level correlates with Hepatitis C virus infection(HCV) and HCV induced liver cirrhosis

目的研究外周血血小板和淋巴细胞比率(Platelet to Lymphocyte Ratio,PLR)与丙型肝炎及丙肝肝硬化的关系,以辅助监测丙型肝炎病情进展,指导临床治疗策略制定。方法选取健康对照组患者30例,丙型肝炎组患者36例,丙肝肝硬化组患者77例,检测3组外周血血小板和淋巴细胞计数并计算PLR,对比3组间PLR水平差异;采用Child-Pugh评分系统,对丙肝肝硬化组77例患者进行评分分级,分析PLR水平同Child-Pugh评分相关性。结果(1)丙型肝炎组(95±35)和丙肝肝硬化组(79±28)患者的PLR水平明显低于健康对照组(117±28)(P<0.05);(2)在丙肝肝硬化患者中,随着Child-Pugh评分升高,PLR水平降低,两者具有线性相关性(|r|=0.41,P<0.05)。结论PLR水平降低同丙型肝炎和丙肝肝硬化患者病情进展密切相关;PLR同丙肝肝硬化患者Child-Pugh评分负相关,可用于辅助预测丙型肝炎患者肝功能损伤情况,评估肝脏纤维化程度,对临床治疗策略制定具有重要意义。

Objective The aim of the this study was to investigate the correlation of PLR with disease severity in patients with HCV infection and HCV related liver cirrhosis. Methods Seventy - seven patients with HCV - induced liver cirrhosis, thirty - six patients with HCV infection but without cirrhosis, and thirty additional healthy controls were enrolled in this study. Serum levels of the counts of platelet and lymphocyte were measured by automated blood analyzers to calculate PLR; Child - Pugh classification was used to evaluate the degree of liver cirrhosis. And the relationship between PLR and Child - Pugh classification was explored. Results （1）When compared with control group （117 ± 28 ）, PLR levels were significantly decreased in HCV infection （95 ± 35 ） and cirrhosis （79± 28 ） （ P 〈 0.05 ）. （2） PLR level was correlated with the severity of liver damage based Child - Pugh classification. Liner analysis result showed PLR level was correlated with the severity of liver cirrhosis （ r = 0.41, P 〈 0.05）. Conclusions PLR levels were found to be closely associated with the development of HCV infection, and HCV induced liver cirrhosis. PLR level, correlated to the histological degree of fibrosis in HCV infection and HCV induced cirrhosis, and can be as a cost - effective and useful marker for the diagnosis and treatment in patients with chronic liver disease.