摘要
目的 探讨红细胞、血小板相关参数在乙肝所致肝硬化患者预后中的应用,丰富随访内容,并为临床制定治疗手段提供参考。方法 对2011年1月-2012年12月于永嘉县人民医院感染科确诊的69例乙肝肝硬化患者进行随访,随访截止至2016年12月。并收集患者的血常规、出凝血和肝肾功能参数,根据有无肝硬化并发症将患者分为并发症组（A组）和无并发症组（B组）,同时收集同期健康体检者的数据作为对照组（C组）,将各组数据进行统计分析。结果 肝硬化患者红细胞体积分布宽度（RDW）、血小板体积分布宽度（PDW）、平均血小板体积（MPV）、红细胞体积分布宽度/血小板计数（PLT）比值（RPR）增加,在A组中,RDW、RPR与总胆红素（Tbil）、肌酐（Cr）均具有良好的相关性。RDW随着Child-pugh等级的升高而增加,与Child-pugh积分具有较好的相关性（R^2=0. 41）。RDW和RPR预测肝硬化并发症的曲线下面积分别为0. 77（0. 66-0. 88）和0. 84（0. 74-0. 94）。二元Logistic回归分析显示,RDW、PDW和Cr均为肝硬化并发症患者的危险因素。结论 红细胞、血小板参数在一定程度上可以作为预测肝硬化患者预后的指标。
Objective To explore the application of red blood cell and platelet parameters in the prognosis of patients with cirrhosis caused by hepatitis B, enrich the follow - up contents, and provide reference for clinical treatment. Methods 69 cases of. hepatitis B cirrhosis diagnosed in the infection department of Yongjia County People＇s Hospital from January 2011 to December 2012 were selected and followed up to December 2016. Blood routine, coagulation, liver and kidney function parame- ters were collected, and divided into complications group （group A） and non complication group （group B） according to the complications of liver cirrhosis, the data of medical examiners at the same time were collected as the control group （ group C ） , and the data of each group were statistically analyzed. Results Red blood cell distribution width （ RDW）, platelet volume distribution width （ PDW）, mean platelet volume （MPV） , red cell volume distribution width/platelet count （PLT） ratio （ RPR ） increased in cirrhotic patients. RDW and RPR have good correlation with total bilirubin（Tbil） and creatinine（Cr） in group A. RDW increased with the increase of Child- pugh level and had a good correlation with the Child -pugh integral （R^2 =0.41 ）. The area under the curves of RDW and RPR for predicting liver cirrhosis was 0.77 （0.66 -0.88 ） and 0.84 （0.74 -0.94 ）, respectively. Binary logistic regression analysis showed that RDW, PDW and CR were all risk factors for patients with cirrhosis complications. Conclusion The parameters of red blood cell and platelet can be used as prognostic predictors in patients with liver cirrhosis.
作者
周腾坚
吴爱荣
陈仁绍
叶剑彪
刘锦
林朦朦
ZHOU Teng-jian;WU Ai-rong;CHEN Ren-shao;YE Jian-biao;LIU Jin;LIN Meng-meng(Clinical Laboratory,Yongfia County People＇s Hospital,Yongjia,Zhejiang 325100,China)
出处
《中国卫生检验杂志》
CAS
2018年第22期2697-2700,共4页
Chinese Journal of Health Laboratory Technology
基金
永嘉县科技发展计划项目(2017304)
关键词
肝硬化
血细胞参数
预后
危险因素
Cirrhosis
Blood cell parameters
Prognosis
Risk factors
作者简介
周腾坚（1985-），男，本科，主管检验师，主要从事临床检验工作
