PLR和NLR与慢性乙型肝炎病毒感染的相关性研究

Correlation between PLR and NLR and chronic hepatitis B virus infection

目的探讨感染HBV慢性病毒性乙型肝炎(CHB)患者血小板与淋巴细胞比值(PLR)及中性粒细胞与淋巴细胞比值(NLR)和疾病严重程度之间的关系。方法选取我院172例HBV患者和40例健康人做对照,回顾性分析PLR和NLR与CHB患者的关系。结果乙型肝炎后肝硬化代偿期(HBV-CC)患者的PLR水平显著低于其他患者(P<0.001)。乙型肝炎后肝硬化失代偿期(HBV-DC)患者的NLR水平显著高于其他任何患者(P<0.001)。在整个CHB患者队列中,患者PLR与血清HBV-DNA水平和血清HBeAg水平之间存在显著相关性。在HBV-CC患者和HBV-DC患者中,患者PLR与血清HBV-DNA均有显著相关。在乙型肝炎病毒携带者(HBV-AC)中,患者PLR与血清HBeAg水平呈正相关(P=0.023)。在HBV-DC患者中,NLR与血清HBeAg水平呈正相关(P=0.033)。Logistic回归预测模型区分HBV-CC和HBV-AC患者的敏感度和特异度分别为96.2%,84.0%。在区分HBV-DC和HBV-CC患者时,NLR值为2.94具有最高的灵敏度(81.8%)和特异性(88.2%)。结论PLR和NLR为有效控制慢性乙型肝炎病毒感染的相关性疾病提供了依据。

Objective This retrospective study aimed to investigate the associations between the platelet-to-lymphocyte ratio(PLR)and neutrophil-to-lymphocyte ratio(NLR)and disease severity in patients with chronic HBV infection-related liver disease(CHB).Methods A total of 172 HBV patients and 40 healthy persons in our hospital were selected as controls.The relationship between PLR and NLR and CHB patients was retrospectively analyzed.Results The mean PLR of patients with post-hepatitis cirrhosis-compensated(HBV-CC)patients was significantly lower than in other patients(P<0.001).The mean NLR of patients with decompensated cirrhosis(HBV-DC)after hepatitis B was significantly higher than any other patient(P<0.001).There was a significant difference between patient PLR and serum HBV-DNA levels and serum HBeAg levels throughout the CHB patient cohort.In both HBV-CC patients and HBV-DC patients,patients with PLR were significantly associated with serum HBV-DNA.In the hepatitis B virus carrier(HBV-AC),patient PLR was positively correlated with serum HBeAg levels(P=0.023).In patients with HBV-DC,NLR was positively correlated with serum HBeAg levels(P=0.033).In the logistic regression prediction model,patients with HBV-CC and HBV-AC were identified with the highest sensitivity and specificity when the predicted probability value was 0.5.When distinguishing between HBV-DC and HBV-CC patients,the NLR value of 2.94 has the highest sensitivity and specificity.Conclusion PLR and NLR provide a basis for the effective control of chronic hepatitis B virus infection-related diseases.