HBV感染患者外周血NLR、PLR的临床意义及其与PTA的关系

Clinical significance and relationship between peripheral platelet-to-lymphocyte ratio,neutrophil-to-lymphocyte ratio and prothrombin activity in hepatitis B patients

目的研究中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)在HBV感染患者中的变化,以及其与HBV感染者凝血酶原活动度(PTA)的相关性。方法收集197例HBV感染者,其中慢性乙型病毒性肝炎(CHB)患者154例(CHB组)、肝硬化患者43例(肝硬化组),另选择94名健康体检者为健康对照组,分别检测3组研究对象的外周血血小板、中性粒细胞、淋巴细胞计数,计算NLR、PLR,另外检测HBV感染患者的PTA,根据PTA中位数分组,观察PTA对HBV感染者血小板、中性粒细胞、淋巴细胞计数和NLR、PLR的影响,分析NLR、PLR与PTA的相关性。结果 3组研究对象的血小板、淋巴细胞及NLR比较差异有统计学意义(P均<0.01);与健康对照组相比,CHB组和肝硬化组患者的血小板、淋巴细胞下降、NLR升高(P均<0.05);CHB组和肝硬化组患者的血小板、淋巴细胞组间比较差异有统计学意义(P均<0.05),2组NLR比较差异无统计学意义(P均>0.05)。3组研究对象的中性粒细胞及PLR组间比较差异均无统计学意义(P均>0.05)。197例HBV感染者的PTA为58(48,85)%,按PTA中位数分为A组(PTA≤58%)98例和B组(PTA>58%)99例。与A组相比,B组的血小板、中性粒细胞及NLR较低(P均<0.01),淋巴细胞较高(P<0.05);组间PLR比较差异无统计学意义(P>0.05)。197例HBV感染患者的PTA与NLR呈负相关(rs=-0.324,P<0.01),与PLR无关(P>0.05)。结论 NLR与HBV感染患者的肝损伤程度有关。

Objective To observe the changes of neutrophil-to-lymphocyte ratio(NLR) and plateletto-lymphocyte ratio(PLR) in patients infected with hepatitis B virus(HBV),and analyze their correlation with prothrombin activity(PTA).Methods A total of 197 HBV-infected patients including 154 cases with chronic hepatitis B(CHB group) and 43 cases with cirrhosis(cirrhosis group) were recruited in this investigation.Ninety-four healthy subjects receiving physical examination were enrolled in the control group.Peripheral platelet,neutrophil and lymph cells were counted in all groups.Both NLR and PLR were calculated.PTA of the HBV-infected patients was detected.All patients were divided into two groups according to the median PTA.The effect of PTA upon the platelet,neutrophil,lymph cell count,NLR and PLR was observed.The correlation between NLR,PLR and PTA was analyzed.Results The platelet,lymphocyte counts and NLR significantly differed among three groups(all P < 0.01).Compared with the control group,the platelet and lymphocyte count were significantly declined,whereas the NLR was considerably increased in the CHB and cirrhosis groups(all P < 0.05).The platelet and lymphocyte count significantly differed between the CHB and cirrhosis groups(both P < 0.05).No statistical significance was noted in the NLR between two groups(P >0.05).No statistical significance was observed in the neutrophil count and PLR among three groups(all P >0.05).The PTA was 58% in 197 HBV-infected patients(range:48-85%).According to the median PTA,all patients were assigned into groups A(PTA ≤58%,n = 98) and B(PTA > 58%,n = 99).Compared with group A,the platelet,neutrophil counts and NLR were significantly lower(all P < 0.01),whereas the lymphocyte count was dramatically higher in group B(P < 0.05).No statistical significance was noted in PLR between groups A and B(P > 0.05).Among 197 HBV-infected patients,PTA was negatively correlated with NLR(rs=-0.324,P < 0.01),whereas it was not associated with PLR(P > 0.05).Conclusion NLR is correlated with the severity of liver injury in HBV-infected patients.