红细胞分布宽度及血清ALT、AST、ALB水平与慢性乙型肝炎肝细胞炎症的关系分析

Relationship between red blood cell distribution width,serum ALT,AST,ALB levels and chronic hepatitis B hepatocyte inflammation

目的分析红细胞分布宽度(RDW)及血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、清蛋白(ALB)水平与慢性乙型肝炎(CHB)肝细胞炎症的关系。方法选取2017年1月至2018年6月在该院治疗的CHB患者100例为CHB组,按照病理分级(炎症程度)将患者分为G0级8例,G1级45例,G2级20例,G3级16例,G4级11例,同期选取健康志愿者100例作为对照组。检测CHB患者RDW、ALT、AST、ALB水平,分析RDW、ALT、AST、ALB水平与病理分级的关系。结果CHB组RDW、ALT、AST水平明显高于对照组,CHB组ALB水平明显低于对照组,差异均有统计学意义(P<0.05)。RDW、ALT、AST水平:G0级<G1级<G2级<G3级<G4级。ALB水平:G0级>G1级>G2级>G3级>G4级。CHB患者不同病理分级RDW、ALT、AST、ALB水平比较,差异有统计学意义(P<0.05)。G0级RDW、ALT水平明显低于G1级,G0级、G1级RDW、ALT、AST水平明显低于G2级、G3级、G4级,G0级、G1级ALB水平明显高于G2级、G3级、G4级,差异均有统计学意义(P<0.05)。G2级RDW、ALT、AST水平明显低于G3级、G4级,G2级ALB水平明显高于G3级、G4级,差异均有统计学意义(P<0.05)。G3级RDW、ALT、AST水平明显低于G4级,G3级ALB水平明显高于G4级,差异有统计学意义(P<0.05)。经Pearson分析,CHB患者的RDW水平与AST水平呈正相关(r=0.693,P<0.001),CHB患者的RDW水平与ALB水平呈负相关(r=-0.198,P=0.048)。结论RDW、ALT、AST、ALB水平均能够反映CHB肝细胞炎症程度,但AST、ALB水平在G0级、G1级之间无显著差异,说明可为不同病理分级CHB的防治提供参考,但AST、ALB水平在G0级、G1级之间不能够区分炎症程度。

Objective To analyze the relationship between red blood cell distribution width(RDW),serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB)levels and chronic hepatitis B(CHB)hepatocyte inflammation.Methods A total of 100 patients with CHB who were treated in our hospital from January 2017 to June 2018 were selected as CHB group.According to the degree of inflammation,the patients were divided into G0(8 cases),G1(45 cases),G2(20 cases),G3(16 cases)and G4(11 cases).Meanwhile,100 healthy volunteers were selected as control group.The RDW,ALT,AST,ALB levels were detection,the relationship between RDW,ALT,AST,ALB levels and pathological grades of CHB patients(degree of inflammation)were analyzed.Results The levels of RDW,ALT and AST in CHB group were significantly higher than those in control group.The level of ALB in CHB group was significantly lower than that in control group(P<0.05).RDW,ALT,AST levels:G0<G1<G2<G3<G4.ALB levels:G0>G1>G2>G3>G4.The levels of RDW,ALT,AST and ALB in different pathological grades of CHB patients were statistically significant(P<0.05).The levels of RDW and ALT at G0 were significantly lower than those at G1,the levels of RDW,ALT and AST at G0 and G1 were significantly lower than those at G2,G3 and G4,while the levels of ALB at G0 and G1 were significantly higher than those at G2,G3 and G4,the difference was statistically significant(P<0.05).The levels of RDW,ALT and AST in G2 were significantly lower than that in G3 and G4.The level of ALB in G2 was significantly higher than those in G3 and G4,and the difference was statistically significant(P<0.05).The RDW,ALT,AST levels in G3 were significantly lower than G4,and the ALB levels in G3 were significantly higher than those in G4,the difference was statistically significant(P<0.05).According to Pearson analysis,the RDW level of CHB patients was positively correlated with AST level(r=0.693,P<0.001),while the RDW level was negatively correlated with ALB level(r=-0.198,P=0.048).Conclusion RDW,ALT,AST,and ALB levels can reflect the degree of CHB hepatocyte inflammation,but the levels of AST and ALB are not significant different between G0 and G1,which can provide reference for the prevention and treatment of CHB in different pathological grades,but AST and ALB level cannot distinguish the degree of inflammation between G0 and G1.