系统炎症指标在乙型肝炎肝硬化及乙型肝炎病毒相关肝细胞癌进展中的预测价值  

Predictive value of systemic inflammatory indexes on progression of hepatitis B-related liver cirrhosis and hepatitis B virus-related hepatocellular carcinoma

作　　者：牛兴杰[1] 刘志慧 崔凤梅[1] 刘耀敏[1] 王艳飞[1] 张国民[1] Niu Xingjie;Liu Zhihui;Cui Fengmei;Liu Yaomin;Wang Yanfei;Zhang Guomin(Department of Infectious Diseases,Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei Province,China)

机构地区：[1]承德医学院附属医院感染性疾病科,河北承德067000

出　　处：《中国肝脏病杂志（电子版）》2020年第2期1-9,共9页Chinese Journal of Liver Diseases：Electronic Version

基　　金：河北省承德市科技支撑项目(201804A028)。

摘　　要：目的探讨系统炎症指标系统炎症指数(system inflammation index,SII)、血小板/淋巴细胞比率(platelet to lymphocyte ratio,PLR)及单核细胞/淋巴细胞比率(monocyte to lymphocyte ratio,MLR)在乙型肝炎肝硬化及乙型肝炎病毒(hepatitis B virus,HBV)相关肝细胞癌(hepatocellular carcinoma,HCC)疾病进展中的预测价值。方法纳入2013年1月1日至2016年12月31日就诊于承德医学院附属医院的110例乙型肝炎患者、86例乙型肝炎肝硬化患者、70例HBV相关HCC患者及54例同期健康体检者为研究对象。检测各组血清白蛋白(albumin,ALB)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBil)、血清C反应蛋白(C reactive protein,CRP)、凝血酶原时间(prothrombin time,PT)、凝血酶原活动度(prothrombin activity,PTA)、中性粒细胞、淋巴细胞、血小板及单核细胞水平。计算SII、PLR及MLR。SII、PLR及MLR与各观察指标的相关性采用Pearson相关性分析。对患者进行随访,根据患者生存状况分为生存组(232例)和病死组(34例)。采用多元Logistic回归分析乙型肝炎肝硬化患者和HBV相关HCC患者病死的独立危险因素。采用受试者工作特征(receiver operator characteristic,ROC)曲线分析SII、PLR及MLR对乙型肝炎肝硬化及HBV相关HCC的诊断价值。结果对照组、乙型肝炎组、乙型肝炎肝硬化组及HBV相关HCC组患者ALB [(45.45±7.23)g/L vs(36.78±7.76)g/L vs(19.46±7.69)g/L vs(12.54±7.39)g/L]、ALT [(34.65±12.36)U/L vs(180.34±119.88)U/L vs(234.68±12.58)U/L vs(486.84±96.38)g/L]、AST [(25.34±13.45)U/L vs(147.42±15.67)U/L vs(263.39±15.84)U/L vs(447.96±16.54)g/L]、TBil [(12.65±1.61)μmol/L vs (69.99±29.80)μmol/L vs(162.63±10.36)μmol/L vs(355.84±23.69)μmol/L]、PT [(11.23±1.62)s vs(19.63±12.11)s vs(30.12±1.62)svs(45.46±12.11)s]、PTA [(80.23±11.09)%vs(62.15±10.43)%vs(50.16±11.54)%vs(40.11±10.37)%]及CRP [(30.23±9Objective To investigate the predictive value of systemic inflammatory indexes[system inflammation index(SII),platelet to lymphocyte ratio(PLR)and monocyte/lymphocyte ratio(MLR)]on progression of hepatitis B-related liver cirrhosis and hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC).Methods Total of 110 patients with hepatitis B,86 patients with hepatitis B-related liver cirrhosis,70 patients with HBV-related HCC and 54 healthy controls in the Affiliated Hospital of Chengde Medical College from January 1 st,2013 to December 31 st,2016 were selected.Serum albumin(ALB),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),C reactive protein(CRP),prothrombin time(PT),prothrombin activity(PTA),neutrophils,lymphocytes,platelets and monocytes were detected.SII,PLR and MLR were calculated.The correlation of SII,PLR and MLR with the above indexes were analyzed by Pearson correlation method.The patients were divided into survival group(232 cases)and death group(34 cases)according to the follow-up results.Independent risk factors for death of patients with hepatitis B-related liver cirrhosis and HBV-related HCC were analyzed by multiple Logistic regression analysis.Diagnostic value of SII,PLR and MLR on hepatitis B-related liver cirrhosis and HBV-related HCC were analyzed by receiver operator characteristic(ROC)curve.Results ALB[(45.45±7.23)g/L vs(36.78±7.70)g/L vs(19.46±7.69)g/L vs(12.54±7.39)g/L],ALT[(34.65±12.36)U/L vs(180.34±119.88)U/L vs(234.68±12.58)U/L vs(486.84±96.38)g/L],AST[(25.34±13.45)U/L vs(147.42±15.67)U/L vs(263.39±15.84)U/L vs(447.96±16.54)g/L],TBil[(12.65±1.61)μmol/L vs(69.99±29.80)μmol/L vs(162.63±10.36)μmol/L vs(355.84±23.69)μmol/L],PT[(11.23±1.62)s vs(19.63±12.11)s vs(30.12±1.62)s vs(45.46±12.11)s],PTA[(80.23±11.09)%vs(62.15±10.43)%vs(50.16±11.54)%vs(40.11±10.37)%]and CRP[(30.23±9.57)mg/L vs(65.78±13.57)mg/L vs(105.69±21.17)mg/L vs(158.39±25.17)mg/L]of patients of control group,hepatitis B group,hepatitis B-related liver cirrhosi

关 键 词：系统炎症指数 血小板/淋巴细胞比率 单核细胞/淋巴细胞比率 肝炎 乙型 肝细胞癌 

分 类 号：R575.2[医药卫生—消化系统] R512.62[医药卫生—内科学] R735.7[医药卫生—临床医学]