血常规参数检测诊断乙型病毒性肝炎疾病严重程度的价值

Value of Blood Routine Parameters in Diagnosing the Severity of Viral Hepatitis B

目的分析平均红细胞体积(mean corpuscular volume,MCV)、红细胞分布宽度(red blood cell distribution width,RDW)、血小板分布宽度(platelet distribution width,PDW)、平均血小板体积(mean platelet volume,MPV)检测对诊断乙型病毒性肝炎的价值。方法选取200例乙型病毒性肝炎患者,均为厦门市中医院门诊和住院部2020年6月—2021年6月所收治,根据患者病情将其分为重症肝炎组(12例)、肝硬化组(34例)、慢性肝炎组(52例)以及急性肝炎组(102例);另外选取同期在厦门市中医院接受健康体检的健康体检人群60例,将其设为对照组。选择全自动血细胞计数仪详细检测全部研究对象的血常规参数,具体包括MCV、RDW、PDW、MPV;并检测血清白蛋白(albumin,ALB)、总胆红素(total bilirubin,TBiL)等肝功能指标。结果对照组、急性肝炎组的RDW、MCV、MPV、PDW比较差异无统计学意义(P>0.05)。重症肝炎组、肝硬化组、慢性肝炎组的RDW水平均明显高于对照组,差异有统计学意义(P<0.05)。肝硬化组、慢性肝炎组的MCV水平均明显高于对照组,差异有统计学意义(P<0.05);慢性肝炎组、肝硬化组的MCV比较差异有统计学意义,差异有统计学意义(P<0.05)。各组的MPV、PDW比较差异无统计学意义(P>0.05)。相关性分析结果发现,RDW与TBiL表现为正相关(P<0.05),与ALB表现为负相关(P<0.05)。MCV与ALB表现为负相关(P<0.05)。结论乙型病毒性肝炎患者的平均红细胞体积、红细胞分布宽度均会出现上升,检测平均红细胞体积、红细胞分布宽度能对肝脏病变程度进行准确反映,具有非常重要的临床应用价值。

Objective To analyze the value of mean red cell volume(MCV),red cell distribution width(RDW),platelet distribution width(PDW)and mean platelet volume(MPV)in the diagnosis of viral hepatitis B.Methods A total of 200 patients with viral hepatitis B were selected,all of whom were hospitalized and outpatients in Xiamen Hospital of Traditional Chinese Medicine from June 2020 to June 2021.According to their conditions,they were divided into the severe hepatitis group(12 cases),the cirrhosis group(34 cases),the chronic hepatitis group(52 cases)and the acute hepatitis group(102 cases).In addition,60 healthy people who received physical examination in Xiamen Hospital of Traditional Chinese Medicine during the same period were selected as the control group.Automatic blood counting apparatus was selected to detect routine blood parameters of all subjects in detail,including MCV,RDW,PDW and MPV.Serum albumin(ALB),total bilirubin(TBiL)and other liver function indexes were detected.Results There was no significant difference in RDW,MCV,MPV and PDW between the control group and the acute hepatitis group(P>0.05).RDW level in the severe hepatitis group,the cirrhosis group and the chronic hepatitis group was significantly higher than that in the control group,the differences were statistically significant(P<0.05).The level of MCV in the cirrhosis group and the chronic hepatitis group was significantly higher than that in the control group,the differences were statistically significant(P<0.05).There was significant difference in MCV between the chronic hepatitis group and the cirrhosis group(P<0.05).There were no statistical significance differences in MPV and PDW among all groups(P>0.05).Correlation analysis showed that RDW was positively correlated with TBiL(P<0.05)and negatively correlated with ALB(P<0.05).MCV was negatively correlated with ALB(P<0.05).Conclusion The mean red blood cell volume and red blood cell distribution width will increase in patients with viral hepatitis B.The detection of mean red blood cell volume and red blood cell distribution width can accurately reflect the degree of liver lesions,which has very important clinic al applic ation value.