摘要
目的评估慢性乙型肝炎病毒(HBV)感染者显著肝脏组织学改变的相关因子预测效果。方法选取2012年10月至2015年12月江苏省泰州市人民医院收治的慢性乙型肝炎初治并接受肝活检术患者157例,回顾性分析其肝组织学和生化检查相关资料。结果清蛋白(ALB)水平与肝组织学炎症水平显著相关(r=-0.236,P=0.003)。ALB、球蛋白(GOLB)、年龄、血小板计数(Plt)、凝血酶原时间(PT)、谷草转氨酶(AST)是显著肝纤维化的独立预测因子(r=-0.291、0.249、0.245、-0.383、0.256、0.235,P=0.001、0.002、0.002、0.001、0.001、0.003)。在谷丙转氨酶(ALT)正常的慢性HBV感染者中,AST、白细胞(WBC)、HBV DNA定量与重度肝纤维化显著相关(r=0.370、0.304、0.287,P=0.001、0.041、0.012);而在ALT异常患者中,年龄、ALB、GOLB、Plt、PT与重度肝纤维化显著相关(r=0.290、0.273、0.317、0.422、0.413,P=0.003、0.001、0.004、0.001、0.002);在HBV e抗原(HBe Ag)阳性患者中,年龄、AST、谷氨酰转肽酶、Plt、PT与肝纤维化显著相关(r=0.295、0.206、0.373、0.475、0.401,P=0.010、0.016、0.027、0.016、0.009);在HBe Ag阴性患者中,ALB、GOLB、WBC、Plt、PT与肝纤维化显著相关(r=0.314、0.207、0.288、0.531、0.320,P=0.001、0.004、0.005、0.001、0.035)。Plt是预测肝纤维化的优秀因子(P=0.001,受试者工作特征曲线下面积为0.805)。结论 Plt在慢性HBV感染者中是一个较好的肝纤维化预测指标。
Objective To evaluate the predictive effect of related factors of significant hepatic histological changes inthe patients with chronic hepatitis B virus（HBV）infection. Methods A total of 157 cases with chronic hepatitis B initialtreatment and receiving liver biopsy in the Taizhou Municipal People′s Hospital from October 2012 to December 2015 were se-lected and their liver histological and biochemical detection data were retrospectively analyzed. Results The albumin（ALB）level was correlated with the liver histological inflammatory level（r=-0.236,P=0.003）.ALB,globulin（GOLB）,age,plateletcount（Plt）,prothrombin time（PT）and aspartate aminotransferaseis（AST）were the independent predictive factors of signifi-cant liver fibrosis（r=-0.291,0.249,0.245,-0.383,0.256,0.235,P=0.001,0.002,0.002,0.001,0.001,0.003）.In the patientswith chronic HBV infection and normal ALT,AST,white blood cell（WBC）and HBV DNA quantification had significant corre-lation with severe hepatic fibrosis（r=0.370,0.304,0.287,P=0.001,0.041,0.012）.In the patients with abnormal ALT,age,ALB,GOLB,Plt and PT had significant correlation with severe hepatic fibrosis（r=0.290,0.273,0.317,0.422,0.413,P=0.003,0.001,0.004,0.001,0.002）.In the patients with HBe Ag positive,age,AST,glutamyl transpeptidase,Plt and PT were signifi-cantly correlated with significant hepatic fibrosis（r=0.295,0.206,0.373,0.475,0.401,P=0.010,0.016,0.027,0.016,0.009）.Inthe patients with HBe Ag negative,ALB,GOLB,WBC,Plt and PT were significantly correlated with significant hepatic fibrosis（r=0.314,0.207,0.288,0.531,0.320,P=0.001,0.004,0.005,0.001,0.035）.Plt was a outstanding factor for predicting liver cir-rhosis（P=0.001,AUC=0.805）. Conclusion Plt is a good predictive indicator for liver cirrhosis in the patients with chronicHBV infection.
作者
王蔚
赵伟
肖丽
咸建春
尹有美
WANG Wei;ZHAO Wei;XIAO Li;XIAN Jianchun;YIN Youmei(School of Medicine,Southeast University,Jiangsu 210009,China;Second Affiliated Hospital,Southeast University,Nanjing,Jiangsu 210003,China;Department of Infection,Taizhou Municipal People′s Hospital,Taizhou,Jiangsu 225300,China)
出处
《现代医药卫生》
2018年第18期2804-2812,共9页
Journal of Modern Medicine & Health
