血常规衍生指标与HBV-DNA载量及ALT关系的研究  

Study on the Relationship Between Blood Routine Derived Indicators and HBV-DNA Load and ALT

作　　者：黎卓华 盖婕敏 何小玲 赖清谊 刘岩 刘德强 周红辉 LI Zhuohua;GAI Jiemin;HE Xiaoling(Laboratory Department of Heshan People s Hospital,Heshan City,Guangdong Province 529700;不详)

机构地区：[1]广东省鹤山市人民医院检验科,529700 [2]广东省鹤山市人民医院肝病科,529700 [3]中山大学附属第五医院

出　　处：《医学理论与实践》2024年第12期1990-1993,1984,共5页The Journal of Medical Theory and Practice

基　　金：江门市医疗卫生领域科技计划项目(2022YL11003)。

摘　　要：目的:选择中性粒细胞淋巴细胞比值(NLR)、血小板淋巴细胞比值(PLR)和血清谷丙转氨酶(ALT)、HBV-DNA作为研究指标,通过分析HBV感染者外周血NLR、PLR的表达与疾病进程及HBV-DNA载量和ALT的关系,探讨NLR和PLR在慢性乙型肝炎患者病情发展的临床意义。方法:收集慢性乙型肝炎患者475例外周血标本,检测血常规、肝功能和乙肝DNA水平,按照HBV-DNA载量水平不同分为阴性组(作为对照组)、低拷贝组、中拷贝组、高拷贝组,分别比较HBV-DNA升高组与阴性组外周血NLR、PLR水平,分析其差异性;同时按照ALT升高水平分为轻、中、重度三个观察组和正常对照组,分别比较观察组与正常组对应的外周血NLR、PLR水平,查找规律;对HBV-DNA阳性的患者在进行药物治疗过程中,监测血NLR、PLR水平变化。结果:NLR与疾病的进展有一定的相关性,其中中拷贝组和高拷贝组与阴性组比较,差异有统计学意义(P均<0.05);而PLR与HBV-DNA未发现有显著相关性,但三个升高组与阴性组比较,PLR数值差异有统计学意义(P均<0.05);随着ALT的逐步升高,NLR也随着升高,轻度和中度升高组,NLR变化不大,但重度升高组与正常组比较,差异有统计学意义(P<0.05);而PLR与ALT的关系不大,差异无统计学意义(P均>0.05);在抗病毒治疗的早期,由于淋巴细胞数量的减少,NLR和PLR会一时性升高。结论:NLR和PLR具有评估慢性HBV感染患者肝脏炎症活动度的临床应用价值,持续动态检测这两个指标的变化对慢性乙肝患者的病情预判有一定的指导作用。Objective:Selecting neutrophil lymphocyte ratio(NLR),platelet lymphocyte ratio(PLR),serum alanine aminotransferase(ALT),and HBV-DNA as research indicators,the clinical significance of NLR and PLR in the development of chronic hepatitis B patients was explored by analyzing the expression of NLR and PLR in peripheral blood of HBV infected individuals and their relationship with disease progression,HBV-DNA load,and ALT.Methods:475 peripheral blood samples were collected from patients with chronic hepatitis B,and blood routine test,liver function and hepatitis B DNA level were detected.According to the different levels of HBV DNA load,they were divided into negative group(as control group),low copy group,medium copy group,and high copy group.The levels of NLR and PLR in peripheral blood of the HBV-DNA elevated group and the control group were compared,and their differences were analyzed.At the same time,the ALT levels were divided into three observation groups:mild,moderate,and severe,and a normal group.The corresponding peripheral blood NLR and PLR levels were compared between the observation groups and the normal group,and the patterns were found.Monitor changes in blood NLR and PLR levels during drug treatment for HBV-DNA positive patients.Results:There is a certain correlation between the NLR of rotavirus and the progression of the disease,among which the difference between the middle and high copy groups and the control group is statistically significant(P<0.05).However,no significant correlation was found between PLR and HBV-DNA,but there was a statistically significant difference in PLR values between the three elevated groups and the control group(P<0.05).As ALT gradually increases,NLR also increases.The NLR changes little in the mild and moderate elevation groups,but the difference between the severe elevation group and the normal group is statistically significant(P<0.05).The relationship between PLR and ALT was not significant,and the difference was not statistically significant(P>0.05).In the early stages

关 键 词：中性粒细胞淋巴细胞比值 血小板淋巴细胞比值 慢性病毒性乙型肝炎 乙肝病毒DNA 谷丙转氨酶 

分 类 号：R446[医药卫生—诊断学]