中性粒细胞与淋巴细胞比值对ALT小于2倍正常值上限的慢性乙型肝炎病毒感染患者肝脏炎症的诊断价值

发布时间：2019-06-02 12:41

【摘要】：目的探讨中性粒细胞与淋巴细胞比值(NLR)评估谷丙转氨酶(ALT)2倍正常值上限的慢性乙型肝炎病毒(HBV)感染患者肝脏炎症活动度的临床价值。方法选取117例ALT2倍正常值上限的慢性HBV感染患者进行肝脏穿刺病理学检查,同时采用全自动生化分析仪和全血细胞分析仪分析患者外周血中ALT、谷草转氨酶(AST)、白蛋白(ALB)、中性粒细胞计数和淋巴细胞计数等指标。采用Pearson相关系数分析患者NLR比值与肝脏炎症指标的相关性。以肝脏穿刺病理学结果为"金标准",通过受试者工作特征曲线(ROC)评估NLR比值在鉴别肝脏炎症活动度≥2的慢性HBV感染患者的敏感度和特异度。结果 117例ALT2倍正常值上限的慢性HBV感染患者中,肝脏炎症活动度分级为G0、G1、G2及G3患者所占比例分别为4.27%、45.28%、44.44%及5.12%。ALT2倍正常值上限的慢性HBV感染患者NLR比值随着肝脏炎症活动度分级升高而逐渐增高,并分别与ALT和AST呈正相关性(r=0.307、0.349,P=0.001)。ROC曲线分析结果显示,NLR比值鉴别肝脏炎症活动度分级≥2的慢性HBV感染患者时,ROC曲线下面积为0.84,显著高于ALT和AST曲线下面积0.65和0.63,差异有统计学意义(P=0.001)。结论部分ALT2倍正常值上限的慢性HBV感染患者肝脏存在较严重的炎症病变,NLR具有评估该部分患者肝脏炎症活动度的临床应用价值。
[Abstract]:Objective to investigate the clinical value of neutrophil / lymphocyte ratio (NLR) in evaluating liver inflammatory activity in patients with chronic hepatitis B virus (HBV) infection with glutamic-pyruvic transaminase (ALT). Methods liver puncture pathology was performed in 117 patients with chronic HBV infection with the upper limit of ALT2 times normal value. ALT, glutamic oxaloacetic transaminase (AST), in peripheral blood was analyzed by automatic biochemical analyzer and whole blood cell analyzer. Albumin (ALB), neutrophil count and lymphocytes count. The correlation between NLR ratio and liver inflammation index was analyzed by Pearson correlation coefficient. According to the results of liver puncture pathology as the "gold standard", the sensitivity and specificity of NLR ratio in distinguishing patients with chronic HBV infection with liver inflammatory activity 鈮，

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