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平均血小板体积升高与乙型肝炎病毒相关慢加急性肝衰竭患者的短期不良预后相关。

Elevated mean platelet volume is associated with poor short-term outcomes in hepatitis B virus-related acute-on-chronic liver failure patients.

作者信息

Han Liyao, Han Tao, Nie Caiyun, Zhang Qian, Cai Junjun

机构信息

The Third Central Clinical College of Tianjin Medical University, 300170 Tianjin, PR China; Department of Hepatology, Tianjin Third Central Hospital, 300170 Tianjin, PR China.

The Third Central Clinical College of Tianjin Medical University, 300170 Tianjin, PR China; Department of Hepatology, Tianjin Third Central Hospital, 300170 Tianjin, PR China; Tianjin Institute of Hepatobiliary Disease, Tianjin Key laboratory of Artificial Cell, The Third Central Hospital of Tianjin, 300170 Tianjin, PR China.

出版信息

Clin Res Hepatol Gastroenterol. 2015 Jun;39(3):331-9. doi: 10.1016/j.clinre.2014.10.006. Epub 2014 Nov 6.

Abstract

BACKGROUND AND AIM

It has been shown that mean platelet volume (MPV) can be used as a prognostic biomarker in some chronic diseases. The aim of the present study is to investigate the possible association between MPV and clinical outcome and prognosis in patients with HBV-related acute-on-chronic liver failure (HBV-ACLF) within 4 weeks.

METHODS

This study included 64 patients with HBV-ACLF, 19 chronic hepatitis B (CHB) patients, 27 patients with hepatitis B-related cirrhosis (CR, Child-Pugh A/B), 51 healthy subjects (healthy controls [HC]). The complete blood counts and biochemical examination of blood were obtained after 12h of fasting. In the ACLF group, the relationships between the prognosis and the MPV were analyzed.

RESULTS

At baseline, a statistically significant increase in MPV was shown in patients with ACLF (median 9.5, range 7.1-14.1) compared with HC (8.0, 7.2-11.9, P<0.001), CR (8.4, 5.9-11.1, P<0.001) and CHB (8.3, 7.3-12.0, P<0.001). The MPV value was positively correlated with model of end-stage liver disease (MELD) score and international normalized ratio (INR). The MPV level was significantly increased in nonsurvivors than survivors. High MPV level showed a significantly lower survival rate (P=0.001). Multivariate logistic regression analysis showed that only MPV level was independent factor predicting poor short-term outcomes.

CONCLUSION

MPV values at presentation were higher among nonsurvivors than survivors, and this parameter was well correlated with liver function parameters and may be used as a predictor for 4-week mortality rate in patients with HBV-ACLF.

摘要

背景与目的

已有研究表明,平均血小板体积(MPV)可作为某些慢性疾病的预后生物标志物。本研究旨在探讨MPV与乙肝相关慢加急性肝衰竭(HBV-ACLF)患者4周内临床结局及预后之间的可能关联。

方法

本研究纳入64例HBV-ACLF患者、19例慢性乙型肝炎(CHB)患者、27例乙肝相关性肝硬化(CR,Child-Pugh A/B级)患者以及51名健康受试者(健康对照[HC])。空腹12小时后进行全血细胞计数及血液生化检查。在ACLF组中,分析预后与MPV之间的关系。

结果

基线时,与HC(8.0,7.2 - 11.9,P<0.001)、CR(8.4,5.9 - 11.1,P<0.001)和CHB(8.3,7.3 - 12.0,P<0.001)相比,ACLF患者的MPV有统计学显著升高(中位数9.5,范围7.1 - 14.1)。MPV值与终末期肝病模型(MELD)评分及国际标准化比值(INR)呈正相关。非存活者的MPV水平显著高于存活者。高MPV水平显示生存率显著降低(P = 0.001)。多因素逻辑回归分析表明,只有MPV水平是预测短期不良结局的独立因素。

结论

非存活者的就诊时MPV值高于存活者,且该参数与肝功能参数密切相关,可作为HBV-ACLF患者4周死亡率的预测指标。

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