红细胞分布宽度和中性粒细胞数淋巴细胞数比值与原发性胆汁性肝硬化患者疾病预后的相关性  

Correlations between Red Blood Cells Distribution Width,Neutrophil/Lymphocyte Ratio and Disease Prognosis of Patients with Primary Biliary Cirrhosis

作　　者：蔡林灵 颜海希[1] 金高兵[1] 李俊[1] 

机构地区：[1]浙江省台州医院检验科,临海317000

出　　处：《中华临床免疫和变态反应杂志》2016年第2期125-130,共6页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的探究红细胞分布宽度（red cell distribution width,RDW）和中性粒细胞数淋巴细胞数比值（neutrophillymphocyte,NLR）与原发性胆汁性肝硬化（primary biliary cirrhosis,PBC）患者的关系。方法选择浙江省台州医院2006年1月至2014年12月54例诊断为PBC的患者,检测其RDW、NLR,运用Spearman相关分析、t检验、多元线性回归进行分析。结果 PBC患者RDW水平为（14.2±1.44）%,显著高于健康对照组的（12.8±0.53）%,差异有统计学意义（t=6.9,P〈0.01）。PBC患者NLR水平为2.22（1.46～3.24）,显著高于健康对照组的1.6（1.29～2.06）,差异有统计学意义（U=1 057.5,P=0.004）。Spearman相关性分析法显示DW与Mayo评分呈正相关（r=0.565,P〈0.01）,与总胆红素呈正相关（r=0.719,P〈0.01）,与白蛋白呈负相关（r=-0.344,P=0.011）。NLR与Mayo评分呈正相关（r=0.274,P=0.04）,与白蛋白呈负相关（r=-0.370,P=0.006）。多元线性回归分析RDW、NLR、红细胞沉降率、CRP与Mayo评分之间的关系,结果显示NLR是影响Mayo评分的主要因素（P=0.000,P=0.018）。PBC患者临床Ⅲ期组RDW水平为（15.02±1.30）%,显著高于Ⅱ期组的（13.15±0.96）%,差异有统计学意义（P〈0.01）。PBC患者进行Child-pugh分级,B＋C级组RDW水平为（14.89±1.38）%,显著高于A级组的（13.89±1.36）%,差异有统计学意义（P=0.04）;而NLR在临床分期与Childpugh分级中均无显著差异。结论 RDW可能被证明是用于估计PBC疾病预后有用的指标,而NLR可能只是一个与PBC患者Mayo评分相关的指标。Objective To investigate the clinical significance of whole blood red cell distribution width（ RDW）and leutrophil / lymphocyte ratio（ NLR） in primary biliary cirrhosis（ PBC）. Methods The medical records of PBC patients who were admitted to Taizhou Hospital of Zhejiang Province between January 2006 and December 2014 were retrospectively reviewed. RDW,NLR were analyzed in a total of 54 patients.Correlations between RDW,NLR,and the patient clinical characteristics were analyzed using the Spearman analysis,t test and multiple linear regression model. Results RDW was 14. 2% ± 1. 44% in PBC patients,which was significantly higher than healthy control group 12. 8% ± 0. 53%,（ t = 6. 9, P 〈0. 01）. NLR was 2. 22（ 1. 46-3. 24） in PBC patients,which was significantly higher than health control group 1. 6（ 1. 29-2. 06）（ U = 1 057. 5, P = 0. 004）. RDW was correlated to Mayo Model using Spearman＇s correlation analysis,r = 0. 565,P 〈0. 01. RDW was correlated to total bilirubin,r = 0. 719,P 〈0. 01. RDW was correlated to total bilirubin,r =- 0. 344,P = 0. 011. NLR was correlated to Mayo Model,r = 0. 274,P 〈0. 04. NLR was correlated to Alb,r =- 0. 370,P = 0. 006. Multiple linear regression analysis was adapted to analyze the relationship between RDW,NLR,ESR,CRP,and Mayo Model. RDW and NLR were major factors affecting Mayo Model（ P = 0. 000,P = 0. 018）. RDW was15. 02% ± 1. 30% in clinical stage Ⅲ,which was significantly higher than clinical stage Ⅱ 13. 15% ±0. 96%（ P 〈0. 01）. For Child-pugh grade,the RDW level of Class B and C 14. 89% ± 1. 38% was significantly higher than Class A group 13. 89% ± 1. 36%（ P = 0. 04）. The NLR was not significantly different between clinical stages and Child-pugh classification. Conclusions RDW may prove to be a useful index to estimate PBC disease prognosis. But NLR may be an indicator associated with Mayo scoring model.

关 键 词：肝硬化 胆汁性 红细胞分布宽度 中性粒细胞淋巴细胞数比值 疾病预后 

分 类 号：R575.22[医药卫生—消化系统] R446.11[医药卫生—内科学]