馬敏

[關鍵詞] 慢性乙型肝炎;中性粒細胞與淋巴細胞比值;紅細胞分布寬度;血小板與淋巴細胞比值

[中圖分類號] R575? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-9701（2021）25-0017-03

Correlation analysis of serum NLR， PLR and RDW with disease development of chronic hepatitis B patients

MA Min

Department of Hepatitis， Xuzhou Infectious Disease Hospital in Jiangsu Province， Xuzhou? ?221100，China

[Abstract] Objective To investigate and analyze the correlation between the neutrophil-lymphocyte ratio （NLR）， platelet-lymphocyte ratio （PLR） and red blood cell distribution width （RDW） in serum and disease progression in patients with chronic hepatitis B. Methods A total of 90 chronic hepatitis B patients who were treated in our hospital from January to November 2020 were selected and divided into 40 severe chronic hepatitis B patients （the severe group） and 50 chronic hepatitis B patients （the normal group） according to their disease progression. Another 50 healthy subjects （the control group） were selected during the same period. The general clinical data of the three groups were compared. Logistic regression analysis and Spearman correlation analysis were used to analyze the correlation between each factor and the disease progression of patients with chronic hepatitis B. Results Compared with the control group， NLR， RDW， AST and ALT in the severe group and the normal group were significantly increased， while PLR was significantly decreased， with statistically significant differences（P<0.05）. Compared with the normal group， NLR， RDW， AST and ALT in the severe group were significantly increased， while PLR was significantly decreased， with statistically significant differences （P<0.05）. According to Logistic multivariate regression analysis， serum NLR， PLR and RDW were the risk factors of the disease progression of chronic hepatitis B patients （P<0.05）. According to Spearman correlation results， NLR and RDW were significantly positively correlated with the disease progression of patients with chronic hepatitis B （r=0.633， 0.376）， and PLR was significantly negatively correlated with the disease progression （r=-0.252）. Conclusion Serum NLR， PLR and RDW are correlated with the disease progression of patients with chronic hepatitis B， which should be closely monitored in clinic.

[Key words] Chronic hepatitis B; Neutrophil-lymphocyte ratio; Red blood cell distribution width; Platelet-lymphocyte ratio

肝臟是人體最大的消化腺，一旦出現(xiàn)問題會給機體帶來極大的不良影響，慢性乙肝是由乙型肝炎病毒感染誘發(fā)而來的，常遷延難愈而進一步發(fā)展為肝硬化、肝癌，預后較差。中性粒細胞與淋巴細胞比值（Neutrophil-lymphocyte ratio，NLR）、血小板與淋巴細胞比值（Platelet-lymphocyte ratio，PLR）是反映慢性炎癥狀態(tài)及免疫防御功能的臨床標志物，檢測方便、重復性高，現(xiàn)已證實與多種腫瘤疾病的進展及預后相關，故而在臨床上備受關注[1-2]。紅細胞分布寬度（Red blood cell distributionwidth，RDW）可反映紅細胞體積的變異程度，臨床上最初用于鑒別診斷貧血，近年應用于肝腎功能不全、急性炎癥、急慢性心力衰竭、肺動脈高壓、高血壓等相關疾病中[3-4]，RDW與乙肝患者關聯(lián)作用的機制可能是患者的肝功能損傷及炎癥狀態(tài)影響造血功能，從而導致血細胞成熟障礙、造血原料不足，以致不成熟的小體積紅細胞進入血液，RDW增多。本研究考察血清內(nèi)NLR、PLR及RDW與慢性乙肝患者病情發(fā)展的相關性，現(xiàn)報道如下。