Karagöz Ergenekon, Tanoğlu Alpaslan, Ülçay Asim, Erdem Hakan, Turhan Vedat, Kara Muammer, Yazgan Yusuf
aVan Military Hospital, Department of Infectious Diseases and Clinical Microbiology, Van Departments of bGastroenterology cInfectious Diseases and Clinical Microbiology, GATA Haydarpasa Training Hospital, Istanbul dGulhane Military Medical Academy, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.
Eur J Gastroenterol Hepatol. 2016 Jul;28(7):744-8. doi: 10.1097/MEG.0000000000000647.
We designed this study to investigate the relationship between the severity of fibrosis and mean platelet volume (MPV), red cell distribution width, and red cell distribution width to platelet ratio (RPR) in patients with chronic hepatitis C (CHC).
Overall, 98 biopsy-proven naïve CHC cases were enrolled in the study. Complete blood count variables, including white blood cell, hemoglobin, platelet count, MPV, red cell distribution width, platelet distribution width as well as aspartate transaminase, alanine transaminase, total bilirubin, albumin, and other routine biochemical parameters, were tested. Liver biopsy samples were assessed according to the Ishak scoring system. Data analyses were carried out using SPSS-15 software. Statistical significance was set at a P-value of less than 0.05.
Of the 98 cases, 80 (81.6%) were men and 18 (18.4%) were women. Fibrosis scores of 69 cases (70.4%) (group 1) were less than 3, whereas 29 cases had fibrosis scores at least 3 (29.6%) (group 2). Significant differences in MPV and RPR were observed between these two groups (MPV: 8.19±1.002 vs. 8.63±0.67 fl, P<0.05; RPR: 0.0526±0.02 vs. 0.0726±0.02, P=0.001). The areas under the curve of the RPR and MPV for predicting significant fibrosis were 0.705 and 0.670, which was superior to the aspartate transaminase-to-alanine transaminase ratio and aspartate transaminase-to-platelet ratio index scores of the study group. Cut-off values were calculated for diagnostic performance, and the cut-off values for MPV and RPR were 8.5 and 0.07 fl, respectively.
MPV and RPR values were significantly higher in patients with CHC, associated with severity, and can be used to predict advanced histological liver damage. The use of MPV and RPR may reduce the need for liver biopsy. Further studies are required to determine the relationship between these parameters and the severity of fibrosis in hepatitis C patients.
我们开展本研究以调查慢性丙型肝炎（CHC）患者纤维化严重程度与平均血小板体积（MPV）、红细胞分布宽度及红细胞分布宽度与血小板比值（RPR）之间的关系。
总体而言，98例经活检证实的初治CHC病例纳入本研究。检测全血细胞计数变量，包括白细胞、血红蛋白、血小板计数、MPV、红细胞分布宽度、血小板分布宽度以及天冬氨酸转氨酶、丙氨酸转氨酶、总胆红素、白蛋白和其他常规生化参数。肝活检样本根据Ishak评分系统进行评估。使用SPSS - 15软件进行数据分析。设定统计学显著性为P值小于0.05。
98例患者中，80例（81.6%）为男性，18例（18.4%）为女性。69例（70.4%）患者（第1组）纤维化评分小于3，而29例患者纤维化评分至少为3（29.6%）（第2组）。两组间MPV和RPR存在显著差异（MPV：8.19±1.002对8.63±0.67fl，P<0.05；RPR：0.0526±0.02对0.0726±0.02，P = 0.001）。RPR和MPV预测显著纤维化的曲线下面积分别为0.705和0.670，优于研究组的天冬氨酸转氨酶与丙氨酸转氨酶比值及天冬氨酸转氨酶与血小板比值指数评分。计算诊断性能的临界值，MPV和RPR的临界值分别为8.5fl和0.07。
CHC患者的MPV和RPR值显著更高，与严重程度相关，可用于预测晚期肝脏组织学损伤。MPV和RPR的应用可能减少肝活检的需求。需要进一步研究以确定这些参数与丙型肝炎患者纤维化严重程度之间的关系。
