机构地区:[1]河南科技大学第一附属医院感染科,河南洛阳471000
出 处:《河南医学研究》2021年第19期3495-3498,共4页Henan Medical Research
摘 要:目的探讨红细胞分布宽度(RDW)在乙型肝炎病毒相关肝硬化失代偿期(HBV-DLC)严重程度中的应用价值。方法选取2016年1月至2019年12月河南科技大学第一附属医院收治的208例乙型肝炎病毒(HBV)相关肝硬化(LC)患者,男142例,女66例,年龄(50.6±6.8)岁,其中HBV相关LC代偿期(HBV-CLC)患者123例(HBV-CLC组),HBV-DLC患者85例(HBV-DLC组)。采用单因素分析两组患者临床资料;采用多因素logistic回归模型探讨临床资料对HBV-LC患者发生HBV-DLC的影响;采用受试者工作特征(ROC)曲线评价诊断效能。结果HBV-CLC组、HBV-DLC组患者RDW变异系数(RDW-CV)、总胆红素、凝血酶原时间、国际标准化比值(INR)及终末期肝病模型(MELD)评分比较,差异有统计学意义(P<0.05),而两组患者白细胞、血小板、白蛋白、谷丙转氨酶、谷草转氨酶及肌酐比较,差异无统计学意义(P>0.05)。将是否有HBV-DLC作为因变量,把RDW-CV、总胆红素、凝血酶原时间、INR及MELD评分纳入logistic回归模型中进行多因素分析,结果提示RDW-CV、MELD评分是HBV-LC患者发生HBV-DLC的独立预测指标(P<0.05)。RDW-CV联合MELD评分诊断时,敏感度、特异度及曲线下面积(AUC)分别为0.924、0.990及0.984。结论RDW升高有助于HBV-LC患者病情严重程度和肝损害程度的判断,RDW能够有效预测HBV-DLC的发生,同时联合MELD评分进行诊断时,诊断效能进一步提高。Objective To explore the application value of red blood cell distribution width(RDW)in the severity of hepatitis B virus-related decompensated liver cirrhosis(HBV-DLC).Methods A total of 208 patients with hepatitis B virus(HBV)-related liver cirrhosis(LC)were selected from January 2016 to December 2019 in the First Affiliated Hospital of Henan University of Science and Technology,including 123 patients with HBV-related compensatory LC(HBV-CLC group)and 85 patients with HBV-DLC(HBV-DLC group).Univariate analysis was used to analyze the clinical data of the two groups.Multivariate logistic regression model was used to explore the influence of clinical data on the occurrence of HBV-DLC in patients with HBV-LC.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy.Results There were statistical differences in RDW coefficient of variation(RDW-CV),total bilirubin,prothrombin time,international normalized ratio(INR)and model for end-stage liver disease(MELD)score between HBV-CLC group and HBV-DLC group(P<0.05),but there were no statistical differences in leukocyte,platelet,albumin,glutamic pyruvic transaminase,glutamic oxaloacetic transaminase and creatinine between the two groups(P>0.05).Taking HBV-DLC as dependent variable,RDW-CV,total bilirubin,prothrombin time,INR and MELD score were included in logistic regression model for multivariate analysis.The results showed that RDW-CV and MELD score were independent predictors of HBV-DLC in patients with HBV-LC(P<0.05).The sensitivity,specificity and area under curve(AUC)of RDW-CV combined with MELD score were 0.924,0.990 and 0.984,respectively.Conclusion The increase of RDW in patients with HBV-LC is helpful to judge the severity of illness and liver damage.RDW can effectively predict the occurrence of HBV-DLC.At the same time,when combined with MELD score,the diagnostic efficiency is further improved.
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