血液学相关指标对慢性乙型肝炎肝硬化的诊断价值

Diagnostic value of hematology related indicators for liver cirrhosis in chronic hepatitis B

目的评估游离脂肪酸( FFA)、红细胞分布宽度(RDW)、中性粒细胞与淋巴细胞比值( NLR)、淋巴细胞与单核细胞比值( LMR)、FIB-4 5 个指标对慢性乙型肝炎肝硬化的诊断价值。方法收集肝硬化组、慢性乙型肝炎组、对照组血液学检测指标,采用 SPSS 19. 0 软件及ROC 曲线评价各指标在肝硬化患者诊断中的价值。结果肝硬化组患者 FFA ( P < 0. 001)、NLR、RDW、FIB-4 的水平明显高于对照组和慢性乙型肝炎组( P 均< 0. 001),FFA、RDW、NLR、LMR、 FIB-4诊断肝硬化的ROC 曲线下面积分别是 0. 607、0. 885、0. 641、0. 775、0. 903;灵敏度分别为 44. 8%、86. 2%、42. 9%、 67. 1%、91. 4%;特异性分别为 77. 3%、80. 4%、84. 0%、77. 9%、78. 5%。结论 FIB-4 仍然是最好的无创性诊断指标,但RDW 也具有较好的诊断性能。NLR、LMR和血清 FFA 等项目有一定的临床价值,其水平变化可以作为诊断肝硬化的参考指标。

Objective To evaluate the diagnostic value of FFA,RDW,NLR,LMR,FIB-4 for HBV related liver cirrhosis. Methods The hematological indexes of cirrhosis group,chronic hepatitis B group and control group were collected. The diagnostic value of each index in cirrhosis patients was evaluated by SPSS19. 0 software and ROC curve. Results FFA,NLR, RDW,FIB-4 and NLR levels in cirrhosis group were significantly higher than those in control group and HBV group ( P < 0. 01). By detecting FFA,RDW,NLR,LMR,FIB-4,the ROC curves of diagnosing cirrhosis were 0. 607,0. 885,0. 641, 0. 775 and 0. 903,respectively;the sensitivity was 44. 8%,86. 2%,42. 9%,67. 1% and 91. 4% respectively;the specificity was respectively 77. 3%,80. 4%,84. 0%,77. 9% and 78. 5%. Conclusion FIB-4 is still the best noninvasive diagnostic index,but RDW also has better diagnostic performance. NLR,LMR and serum FFA have certain clinical value,and their changes can be used as a reference index for the diagnosis of liver cirrhosis.