血常规检查在丙肝相关肝脏疾病中的临床价值探讨

Clinical Value of Blood Routine Examination in Liver Disease Caused by HCV Infection

目的观察血常规检测(PLR、NLR等指标)在丙肝病毒感染所致肝脏疾病的不同病情阶段的变化情况,寻求血常规监测疾病的临床应用价值。方法选择2017年1月至2018年1月在天津市第三中心医院肝胆内科就诊的丙型肝炎病毒感染患者112例(慢性丙型病毒性肝炎组47例,慢性丙型病毒性肝硬化组65例)。同时,从预防保健中心体检人群中随机选择30例作为健康对照组。然后我们再根据患者接受抗病毒治疗后载量的变化将慢性丙型病毒性肝炎和慢性丙型病毒性肝硬化分为亚组(即慢性丙型肝炎清除组21例、慢性丙型肝炎未清除组26例、慢性丙型病毒性肝硬化清除组21例、慢性丙型病毒性肝硬化未清除组44例)。应用SPSS 21.0统计软件对各组及各亚组血液学指标进行相关统计学分析。结果通过NLR、PLR数据分析可见丙型肝炎病毒未清除组比健康组PLR有所下降,差异具有统计学意义,NLR差异不具统计学意义;肝病患者与健康对照组相比PLR降低,差异具有统计学意义,NLR差异同样不具统计学意义;HCV所致肝硬化组比慢性丙型肝炎组PLR降低,差异具有统计学意义(P均小于0.05)。通过ROC曲线分析可见在健康人与肝病患者中PLR诊断效能较高;而慢性丙型肝炎患者与HCV致肝硬化患者中的血小板数P和淋巴细胞数L具有更高诊断价值。结论对血常规检测指标进行相关性统计分析和ROC曲线分析发现PLR和NLR对于HCV感染及相关肝脏疾病的临床诊断及治疗有一定的预测意义,我们可以将PLR或NLR或其它血液学指标联合监测,以便寻求更高的诊断价值(高特异度、高灵敏度)。

Objective To observe the changes of blood routine detection(PLR,NLR and other indicators)in different stages of liver disease caused by hepatitis C virus infection,and to seek the clinical application value of blood routine monitoring disease.Methods 112patients with hepatitis C virus infection who were admitted to the Department of Hepatobiliary Medicine of Tianjin Third Central Hospital from January 2017to January 2018(47patients with chronic hepatitis C and 65patients with chronic hepatitis C cirrhosis).At the same time,30patients were randomly selected from preventive health center for healthy control group.Then we divided the chronic hepatitis C and chronic hepatitis C cirrhosis into subgroups according to the changes in the load of patients after receiving antiviral therapy(ie,21patients in the chronic hepatitis C removal group,26patients with chronic hepatitis C not clear,21patients with chronic hepatitis C cirrhosis clearance and 44patients with chronic hepatitis C cirrhosis).Statistical analysis was performed on the hematological parameters of each group and each subgroup using SPSS 21.0statistical software.Results Through NLR and PLR data analysis,there was a decrease in the PLR in the uncleared group of hepatitis c virus,and the difference was statistically significant,and the difference of NLR was not statistically significant.Compared with the healthy control group,the PLR decreased,the difference was statistically significant,and the NLR difference was not statistically significant.The HCV induced cirrhosis group was lower than the PLR of chronic hepatitis c group,and the difference was statistically significant(P<0.05).The ROC curve analysis showed that PLR was more effective in patients with healthy and liver diseases.The number of platelet count P and lymphocyte number L in patients with chronic hepatitis c and HCV in patients with cirrhosis have higher diagnostic value.Conclusion Statistical analysis of routine blood test indexes correlation and ROC curve analysis found that PLR and NLR for HCV infection and related liver disease clinical diagnosis and treatment has certain prediction.Correlation statistical analysis and ROC curve analysis of blood routine test indicators found that PLR and NLR have certain predictive significance for the clinical diagnosis and treatment of HCV infection and related liver diseases.We can jointly monitor PLR,NLR and other hematological indicators.In order to seek higher diagnostic value(higher specificity,higher sensitivity).