慢性乙型肝炎者外周血SAA/CRP、NLR水平与HBV-DNA载量、病情程度的相关性分析  

Correlation Analysis of Peripheral Blood SAA/CRP and NLR Levels with HBV-DNA Lload and Degree of Disease in CHB Patients

作　　者：陈春燕[1] 樊子勉 CHEN Chunyan;FAN Zimian(Dept.of Clinical Laboratory,Dazhou Hospital of Integrated Traditional Chinese and Western Medicine,Dazhou Sichuan 635000;Dept.of Clinical Laboratory,The 6th People’s Hospital of Chengdu,Chengdu Sichuan 610000,China)

机构地区：[1]达州市中西医结合医院检验科,四川达州635000 [2]成都市第六人民医院检验科,四川成都610051

出　　处：《昆明医科大学学报》2024年第5期144-150,共7页Journal of Kunming Medical University

基　　金：成都市医学科研基金资助项目(2021353)。

摘　　要：目的探究慢性乙型肝炎(chronic hepatitis B,CHB)患者外周血淀粉样蛋白A(serum amyloid A,SAA)与C反应蛋白(C-reactive protein,CRP)比值(SAA/CRP)、中性粒细胞与淋巴细胞比值(neutrophils lymphocytes ratio,NLR)水平与乙型肝炎病毒-脱氧核糖核酸(HBV-DNA)载量及病情程度的相关性。方法选取2020年6月至2022年6月达州市中西医结合医院100例CHB患者作为研究组,根据病情程度分为轻度(单纯CHB,n=36)、中度(乙肝代偿期肝硬化,n=33)和重度(乙肝失代偿期肝硬化,n=31)。另选同期、同年龄段50例健康志愿者作为对照组,比较研究组不同病情程度、对照组一般资料、血清SAA/CRP、NLR水平,并比较研究组不同HBV-DNA载量患者血清SAA/CRP、NLR水平,分析CHB患者血清SAA/CRP、NLR水平与HBV-DNA载量、病情程度的相关性;所有患者均行抗病毒治疗,治疗24周,比较不同抗病毒疗效患者治疗前、治疗后12周、24周血清SAA/CRP、NLR水平及变化值,分析治疗前后血清SAA/CRP、NLR水平变化值预测疗效的价值。结果重度CHB患者血清SAA/CRP、NLR水平>中度CHB患者>轻度CHB患者>健康人群(P<0.05);高载量患者血清SAA/CRP、NLR水平>中载量患者>轻载量患者(P<0.05);CHB患者血清SAA/CRP、NLR水平与HBV-DNA载量(r=0.756、0.709)、病情程度(r=0.776、0.745)呈正相关(P<0.05);无应答患者治疗后12周、24周外周血SAA/CRP、NLR水平均高于应答患者,变化值均低于应答患者(P<0.05);SAA/CRP△1、NLR△1单独预测的AUC分别为0.752、0.773,联合预测△1的AUC为0.861;SAA/CRP△2、NLR△2单独预测的AUC分别为0.796、0.819,联合预测△2的AUC为0.967,大于联合预测△1的AUC(P<0.05)。结论CHB患者的SAA/CRP、NLR与CHB HBV-DNA载量及病情程度具有相关性,临床可通过其水平变化评估病情及预测预后。Objective To investigate the correlation and clinical significance of peripheral blood serum amyloid A(SAA)to C-reactive protein(CRP)ratio(SAA/CRP),neutrophils lymphocytes ratio(NLR)and HBVDNA levels and disease severity in patients with chronic hepatitis B(CHB),so as to find out the correlation between SAA and CRP(SAA/CRP),neutrophils lymphocytes ratio(NLR)and hepatitis B virus-deoxyribonucleic acid(HBV-DNA).Methods From June 2020 to June 2022,100 patients with CHB in our hospital were selected as the study subject and were divided into the mild group(simple CHB,36 cases),the moderate group(cirrhosis in the compensated stage of hepatitis B,33 cases)and the severe group(cirrhosis in the decompensated stage of hepatitis B,31 cases)according to the degree of disease.And at the same time,another 50 healthy volunteers with the same age were selected as the control group.Different disease degrees,general information,serum SAA/CRP and NLR levels in the control group,and serum SAA/CRP and NLR levels in patients with different HBV-DNA loads in the study group were compared respectivly and the correlation between the serum SAA/CRP and NLR levels in patients with CHB and HBV-DNA loads and disease degrees were analyzed.The correlation between the serum SAA/CRP,NLR levels and HBV-DNA load and the degree of disease in CHB patients was analyzed.All patients were treated with the antiviral therapy for 24 weeks,and serum SAA/CRP,NLR levels and the change values of patients with different antiviral efficacies were compared before the treatment and 12 weeks and 24 weeks after the treatment and the value of the change values of serum SAA/CRP,NLR levels before and after the treatment was analyzed so as to predict the efficacy of the therapy.Results Serum SAA/CRP and NLR levels in severe patients>moderate patients>mild patients>control group(P<0.05);serum SAA/CRP and NLR levels in high carrier patients>moderate carrier patients>mild carrier patients(P<0.05);serum SAA/CRP and NLR levels in CHB patients were positively correlated with

关 键 词：慢性乙型肝炎 乙型肝炎病毒-脱氧核糖核酸 外周血淀粉样蛋白A C反应蛋白 中性粒细胞 淋巴细胞 

分 类 号：R446[医药卫生—诊断学]