红细胞体积分布宽度在乙型肝炎相关原发性肝癌中的预测价值  

Predictive value of the red blood cell distribution width(RDW)for the development of hepatitis B virus related primary hepatocellular carcinoma

作　　者：韩竖霞 饶珺[1,2] 彭晓明[1,2] 赵友云[1,2] HAN Shu-xia;RAO Jun;PENG Xiao-ming;ZHAO You-yun(Department of Clinical Laboratory,Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan,430061,China;Hubei Province Academy of Traditional Chinese Medicine,Wuhan,430074,China)

机构地区：[1]湖北省中医院检验科,湖北武汉430061 [2]湖北省中医药研究院

出　　处：《中西医结合肝病杂志》2021年第11期1028-1030,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：湖北省卫生和计划生育委员会科研项目(No.WJ2017M148)。

摘　　要：目的:分析红细胞体积分布宽度(RDW)在乙型肝炎病毒(HBV)相关各种肝病中的变化情况,探讨RDW在乙型肝炎相关原发性肝癌中的预测价值。方法:通过回顾性分析方法收集2015年1月至2017年12月在我院就诊的211例HBV感染相关性肝病患者的临床资料,其中慢性乙型肝炎(CHB)患者73例、乙型肝炎相关性肝硬化(HBV-LC)患者73例、乙型肝炎相关性原发性肝癌(HBV-HCC)患者65例。选取同期健康体检人员60例为对照组。采用SPSS 20.0软件分析各组患者及健康体检人员的肝功能各项指标和RDW水平的差异;探讨HBV-HCC组患者的RDW与肝功能各指标之间的相关性及RDW对其的诊断价值。结果:CHB组、HBV-LC组和HBV-HCC组患者肝功能各指标和RDW水平与对照组比较,差异均有统计学意义(均P<0.05),且HBV-LC组、HBV-HCC组患者的RDW水平比对照组和CHB组高,差异均有统计学意义(均P<0.05)。对HBV-HCC组患者的RDW与肝功能各指标的相关性分析发现,RDW与AST、GGT、TBil、DBil、ALP呈正相关性,与Alb呈负相关性,均具有统计学意义(P<0.05)。通过ROC曲线分析可见HBV相关肝病患者RDW的曲线下面积(AUC)为0.729,cutoff值的敏感性为47.9%,特异性为98.3%;而在HBV-HCC患者时AUC为0.802,cutoff值的敏感性为73.8%,特异性为79.5%。结论:HBV感染后不同肝病患者的RDW水平有差异,并与肝功能指标呈一定的相关性,RDW对于判断HBV感染后是否发展为原发性肝癌有一定的预测价值。Objective:To analyze the changes of red cell distribution width(RDW)in different stages of 1iver disease caused by hepatitis B virus infection,and to investigate the predictive value of RDW in hepatitis B associated primary liver cancer.Methods:The liver function indexes(ALT,AST,ALP,GGT,TBIL,DBIL,TP,ALB)and RDW of 211 patients with different outcomes after hepatitis B infection(including 73 patients with chronic hepatitis B,73 patients with cirrhosis after hepatitis B,and 65 patients with primary liver cancer after hepatitis B)were analyzed retrospectively.At the same time,60 healthy physical examinees were selected as healthy control group.Statistical analysis was performed on the hematological parameters of each group and each subgroup using SPSS 20.0 statistical software.Results:There were significant differences in liver function indexes and RDW levels between the chronic hepatitis B group、the liver cirrhosis group、Primary liver cancer group and the healthy control group(P<0.05).The levels of RDW in the HBV-related liver cirrhosis group and the HBV-related primary liver cancer group were higher than those in the healthy control group and the chronic liver cancer group,and the differences were statistically significant(P<0.05).The correlation analysis of RDW and liver function indexes in the HBV-related primary liver cancer group showed that RDW was positively correlated with AST GGT TBIL DBIL ALP,and negatively correlated with ALB,both of which were statistically significant(P<0.05).ROC curve analysis showed that the area under the curve of RDW in patients with hepatitis B-related liver diseases was 0.729,and the sensitivity of cutoff value was 47.9%,and the specificity was 98.3%.The area under the curve(AUC)in HBV-HCC patients was 0.802,and the sensitivity of cutoff value was 73.8%,and the specificity was 79.5.Conclusion:There were differences in RDW levels in different liver diseases after HBV infection.RDW has a certain correlation with liver function indicators,which has a certain predictive value for

关 键 词：肝硬化 肝癌 红细胞体积分布宽度 预测价值 

分 类 号：R735.7[医药卫生—肿瘤]