血小板与白细胞比值在2型糖尿病合并乙型肝炎病毒感染中的临床意义

Clinical significance of platelet to leukocyte ratio in type 2 diabetes mellitus complicated with hepatitis B virus infection

目的 探讨血小板与白细胞比值(RATIO)在2型糖尿病(DM)合并乙肝感染(DM-HBV)中的临床意义。方法 用统计学方法分析2017年1月-2021年6月就诊于合肥市第二人民医院的单纯DM和DM-HBV共127例患者的临床检测结果。对DM-HBV组RATIO与HBV DNA定量、肝功能指标及HBV DNA病毒量与糖化血红蛋白(HbA1c)进行相关性分析。同时对DM-HBV组中部分病例经联合抗病毒治疗后,部分指标的变化进行比较。观察RATIO联合病毒量与丙氨酸氨基转移酶/天门冬氨酸氨基转移酶比值(ALT/AST)在预测早期肝损伤中的差异性。结果 与DM组相比,DM-HBV组肝功能中ALT、AST和总胆红素(TBIL)增高,血小板(PLT)和RATIO降低,差异均有统计学意义(P<0.05)。RATIO与HBV DNA病毒量、TBIL、ALT及AST均呈正相关(c=0.44、0.66、0.32、0.31,P<0.05);HBV DNA病毒量与HbA1c呈正相关(R^(2)=0.44,P<0.05)。经联合治疗后,DM-HBV患者HbA1c和RATIO数值降低。比较ROC曲线下面积,RATIO联合病毒量为0.91(95%CI:0.81~1.00,P<0.05),ALT/AST为0.73(95%CI:0.61~0.84,P<0.05)。结论 RATIO在辅助评价合并感染患者病情,判断患者病情活动度方面有着明显的优越性。

Objective To investigate the clinical significance of platelet to leukocyte ratio(RATIO)in type 2 diabetes mellitus(DM)complicated with hepatitis B infection(DM-HBV).Methods The clinical test results of 127 patients with simple DM and DM-HBV were analyzed by statistical method.The correlation between RATIO and HBV DNA viral load,RATIO and liver function index,HBV DNA viral load and glycated hemoglobin(HbA1 c)in DM-HBV group were analyzed.At the same time,the changes of some indexes in DM-HBV group after co-therapy were compared.The difference of RATIO combined viral load and alanine aminotransferase(ALT)/aspartate aminotransferase(AST)in predicting early liver injury was observed.Results Compared with DM group,liver function indicators ALT,AST and total bilirubin(TBIL)were increased in DM-HBV group(P<0.05),while platelet(PLT)and RATIO were decreased in blood routine(P<0.05).RATIO was positively correlated with HBV DNA viral load,TBIL,ALT and AST(R^(2)=0.44,0.66,0.32,0.31,P<0.05).The quantity of HBV DNA was positively correlated with HbA1 c(R^(2)=0.44,P<0.05).After co-antiviral therapy,HbA1 c and RATIO of DM-HBV patients were decreased.Compared with the area under the ROC curve,the RATIO combined with viral load was 0.91(95%CI:0.81-1.00,P<0.05),ALT/AST was 0.73(95%CI:0.61-0.84,P<0.05).Conclusion RATIO had obvious superiority in assisting to evaluate the illness of patients with type 2 diabetes mellitus complicated with hepatitis B infection and judging the liver function of patients.