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平均血小板体积能否用于确定慢性乙型肝炎患者肝纤维化或炎症的严重程度?

Can mean platelet volume determine the severity of liver fibrosis or inflammation in patients with chronic hepatitis B?

机构信息

Department of Infectious Diseases and Clinical Microbiology, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey.

出版信息

Eur J Gastroenterol Hepatol. 2013 May;25(5):606-12. doi: 10.1097/MEG.0b013e32835d08da.

Abstract

AIMS

We aimed to determine whether mean platelet volume (MPV) is one of the variables that determine the severity of liver fibrosis and inflammation.

MATERIALS AND METHODS

Patients with chronic hepatitis B virus (HBV) infection were divided into two groups: patients with fibrosis scores of 0-3 and 4-6 and patients with histologic activity index scores of 0-9 and 10-18 (according to the Ishak Scoring System). The independent variables determining the severity of liver fibrosis and inflammation were investigated.

RESULTS

Two hundred and thirty-eight patients were included in this retrospective study. The fibrosis scores of 29 patients (12.2%) were higher than 3. The independent variables that determined the severity of the fibrosis score were a high level of serum γ-glutamyl transferase and a low blood platelet count (odds ratio and P values were 1.016 and 0.004 for γ-glutamyl transferase, and 0.986 and 0.002 for blood platelet count). The histologic activity indexes of 38 patients (16%) were higher than 9. The independent variables determining the severity of liver inflammation were serum HBV DNA, γ-glutamyl transferase, and globulin levels and the MPV [odds ratio and P values were, respectively, 0.1001 and 0.046 for HBV DNA (×10); 1.016 and 0.004 for γ-glutamyl transferase; 2.247 and 0.039 for globulin; and 1.488 and 0.004 for the MPV]. The sensitivity, specificity, and positive predictive value and negative predictive value of the model predicting the severity of liver inflammation were 60.5, 83, 40.3, and 91.7%, respectively (area under the receiver-operating characteristic curve=0.775, P=0.0001).

CONCLUSION

MPV may provide useful information to predict the degree of liver inflammation along with other markers.

摘要

目的

我们旨在确定平均血小板体积(MPV)是否是决定肝纤维化和炎症严重程度的变量之一。

材料和方法

将慢性乙型肝炎病毒(HBV)感染患者分为两组:纤维化评分 0-3 分和 4-6 分的患者,以及组织学活动指数评分 0-9 分和 10-18 分的患者(根据 Ishak 评分系统)。研究了确定肝纤维化和炎症严重程度的独立变量。

结果

本回顾性研究纳入了 238 例患者。29 例(12.2%)患者的纤维化评分较高,为 3 分以上。决定纤维化评分严重程度的独立变量是血清γ-谷氨酰转移酶水平升高和血小板计数降低(γ-谷氨酰转移酶的比值比和 P 值分别为 1.016 和 0.004,血小板计数的比值比和 P 值分别为 0.986 和 0.002)。38 例(16%)患者的组织学活动指数较高,为 9 分以上。决定肝炎症严重程度的独立变量是血清 HBV DNA、γ-谷氨酰转移酶和球蛋白水平以及 MPV[比值比和 P 值分别为 HBV DNA(×10)的 0.1001 和 0.046;γ-谷氨酰转移酶的 1.016 和 0.004;球蛋白的 2.247 和 0.039;MPV 的 1.488 和 0.004]。预测肝炎症严重程度的模型的灵敏度、特异度、阳性预测值和阴性预测值分别为 60.5%、83%、40.3%和 91.7%(受试者工作特征曲线下面积=0.775,P=0.0001)。

结论

MPV 可能与其他标志物一起提供预测肝炎症程度的有用信息。

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