TyG、PLR与代谢相关脂肪性肝病合并慢性乙型肝炎患者肝纤维化的关系研究  

Study on the Relationship between TyG,PLR and Liver Fibrosis in Patients with Metabolic Associated Fatty Liver Disease Complicated with Chronic Hepatitis B

作　　者：王燚鑫 胡梦茹 赵永红 衣桂荣 陈爱荣[3] WANG Yi-xin;HU Meng-ru;ZHAO Yong-hong;YI Gui-rong;CHEN Ai-rong(Second Clinical Medical College of Lanzhou University,Lanzhou,Gansu,730000,China;Department of Gastroenterology,The Second Hospital of Lanzhou University,Lanzhou,Gansu,730030,China;Department of Endocrinology and Metabolism,The Second Hospital of Lanzhou University,Lanzhou,Gansu,730030,China)

机构地区：[1]兰州大学第二临床医学院,甘肃兰州730000 [2]兰州大学第二医院消化内科,甘肃兰州730030 [3]兰州大学第二医院内分泌与代谢病科,甘肃兰州730030

出　　处：《现代生物医学进展》2024年第14期2694-2698,2693,共6页Progress in Modern Biomedicine

基　　金：甘肃省科技计划项目基础研究计划(22JR11RA068)。

摘　　要：目的:探讨甘油三酯-葡萄糖指数(TyG)、血小板/淋巴细胞计数(PLR)与代谢相关脂肪性肝病(MAFLD)合并慢性乙型肝炎(CHB)患者肝纤维化的关系,以期为临床诊疗工作提供帮助。方法:选取兰州大学第二医院2021年1月-2023年8月收治的MAFLD合并CHB患者100例。根据肝纤维化4因子指数(FIB-4)将患者分为可排除肝纤维化组(n=44)、不确定肝纤维化组(n=38)和肝纤维化组(n=18),比较3组间患者基线资料和实验室检验指标。运用Spearman分析FIB-4指数与临床指标的相关性,多因素Logistic回归分析肝纤维化的影响因素,受试者工作特征曲线(ROC)分析TyG及PLR评估肝纤维化的效能。结果:肝纤维化组患者年龄最大,ALT、AST、GGT、DBIL、TyG水平最高,舒张压、淋巴细胞计数、PLT、LDL-C、UA、PLR、TC/HDL-C、LDL/HDL-C水平最低。FIB-4指数与年龄、DBIL、TG/HDL-C、TyG呈正相关(均P<0.01),与ALB、TC/HDL-C、LDL/HDL-C、PLR呈负相关(均P<0.01)。年龄、DBIL、TyG、LDL/HDL-C是MAFLD合并CHB患者肝纤维化的独立危险因素(均P<0.05)。ROC曲线分析显示TyG预测肝纤维化时的曲线下面积(AUC)为0.674,敏感度为88.9%,特异度为56.1%;PLR预测肝纤维化时的AUC为0.718,敏感度为77.8%,特异度为65.9%。结论:TyG、PLR与MAFLD合并CHB肝纤维化严重程度有关,两者对MAFLD合并CHB患者中肝纤维化的发生有较高的预测价值,可用于早期识别MAFLD合并CHB患者肝纤维化的风险。Objective:To investigate the relationship between triglyceride glucose index(TyG),platelet-to-lymphocyte ratio(PLR)and liver fibrosis in patients with metabolic associated fatty liver disease(MAFLD)complicated with chronic hepatitis B(CHB),in order to provide help for clinical diagnosis and treatment.Methods:100 patients with MAFLD combined with CHB were selected from The Second Hospital of Lanzhou University from January 2021 to August 2023.The patients were divided into the excluded liver fibrosis group(n=44),the uncertain liver fibrosis group(n=38)and the liver fibrosis group(n=18)according to the liver fibrosis 4 factor index(FIB-4).Baseline data and laboratory test indicators were compared among the three groups.Spearman was used to analyze the correlation between FIB-4 index and clinical indicators.Multivariate logistic regression was used to analyze the influencing factors of liver fibrosis.Receiver operating characteristic curve(ROC)was used to analyze the efficacy of TyG and PLR in evaluating liver fibrosis.Results:The patients in the liver fibrosis group were the oldest,the levels of ALT,AST,GGT,DBIL and TyG were the highest,and the levels of diastolic blood pressure,lymphocyte count,PLT,LDL-C,UA,PLR,TC/HDL-C and LDL/HDL-C were the lowest.FIB-4 index was positively correlated with age,DBIL,TG/HDL-C and TyG(all P<0.01),and negatively correlated with ALB,TC/HDL-C,LDL/HDL-C and PLR(all P<0.01).Age,DBIL,TyG and LDL/HDL-C were independent risk factors for liver fibrosis in MAFLD patients with CHB(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of TyG in predicting liver fibrosis was 0.674,the sensitivity was 88.9%,and the specificity was 56.1%.The AUC of PLR in predicting liver fibrosis was 0.718,the sensitivity was 77.8%,and the specificity was 65.9%.Conclusion:TyG and PLR are related to the severity of liver fibrosis in MAFLD patients with CHB.Both of them have high predictive value for the occurrence of liver fibrosis in MAFLD patients with CHB,and can be used to identify the risk

关 键 词：TyG PLR 代谢相关脂肪性肝病 慢性乙型肝炎 肝纤维化 

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