基线血小板水平可预测代偿期乙型肝炎肝硬化患者抗病毒治疗后的临床转归

Baseline platelet as an independent predictor for clinical outcome after antiviral therapy in compensated HBV-related cirrhosis patients

目的探索代偿期乙型肝炎肝硬化患者基线指标中可预测肝脏相关终点事件(liver related events,LRE)的危险因素。方法在前瞻性随访的代偿期乙型肝炎肝硬化患者队列中,根据是否发生LRE将患者分为发生LRE组和未发生LRE组,比较两组患者基线特征,并分析基线指标中可预测LRE的危险因素。结果共入组106例代偿期乙型肝炎肝硬化患者并随访3年,发生终点事件者18例(17.0%)。发生LRE组的基线血小板水平低于未发生LRE组(P<0.05)。两组患者治疗过程中可见HBV DNA均显著下降。抗病毒治疗后两组血小板水平均增加,但未发生LRE组增加程度高于已发生LRE组(P<0.05)。Cox比例风险模型分析显示,基线血小板水平是预测LRE的独立危险因素(P<0.01)。结论基线血小板水平是预测代偿期乙型肝炎肝硬化患者发生肝脏相关终点事件的独立危险因素。

Objective To investigate baseline indicators which could be predictors for liver-related events（LRE）after antiviral therapy in compensated hepatitis B virus（HBV）-related cirrhosis patients.Methods A prospective cohort of compensated HBV-related liver cirrhosis patients were followed up for observation of LRE.According to whether LRE occurred or not,patients were divided into LRE group and non-LRE group.Results A total of 106 patients with compensated HBV-related cirrhosis were recruited and followed up for 3 years.There were 18 patients（17.0%）developing LRE after 3-year follow-up,whose baseline platelet counts were lower than those in patients without LRE（P〈0.05）.The Cox proportional hazards model showed that baseline platelet was an independent predictor for LRE.Furthermore,the platelet counts increased more dramatically in patients without LRE than those in patients with LRE after antiviral treatment（P〈0.05）.HBV DNA decreased significantly in both groups after treatment,without significant difference between 2 groups.Conclusion Baseline platelet is an independent predictor for LRE in patients with compensated HBV-related cirrhosis who received antiviral therapy.