Department of Clinical Laboratory, Xiangya Hospital Central South University, No. 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China.
Department of Clinical Laboratory, Xiangya Hospital Central South University, No. 87 Xiangya Road, Changsha, Hunan 410008, People's Republic of China.
Int Immunopharmacol. 2017 Oct;51:1-8. doi: 10.1016/j.intimp.2017.07.007. Epub 2017 Jul 28.
This retrospective study aimed to investigate the associations between the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) and disease severity in patients with chronic HBV infection-related liver disease (CHB).
Patients with CHB were retrospectively identified. Clinical data for 172 HBV-infected patients and 40 healthy controls were collected from the electronic patient medical record system database of our hospital.
HBV-related-compensated-cirrhosis patients (HBV-CC patients) had a significantly lower mean PLR than did other patients (P<0.001). HBV-related-decompensated-cirrhosis patients (HBV-DC patients) had a significantly higher mean NLR than did any other patients (P<0.001). In the entire cohort of CHB patients, significant correlations were observed between the PLR and both serum HBV DNA (r=0.264, P<0.001) and serum HBeAg (r=0.240, P=0.002). The PLR was significantly correlated with serum HBV DNA in both HBV-CC patients (r=-0.116, P=0.044) and HBV-DC patients (r=0.456, P=0.008). In HBV-Active-Carriers patients (HBV-AC patients), the PLR was positively correlated with serum HBeAg level (r=0.321, P=0.023). In HBV-DC patients, the NLR was positively correlated with serum HBeAg level (r=0.372, P=0.033). In the logistic regression prediction model, a predictive probability cutoff of 0.392 had the highest sensitivity and specificity (sensitivity, 91.2%; specificity, 84.0%) in distinguishing between HBV-CC and HBV-AC patients. A NLR cutoff value of 2.94 had the highest sensitivity and specificity (sensitivity, 81.8%; specificity, 88.2%) in distinguishing between HBV-DC and HBV-CC patients.
The PLR and NLR partially reflect the amounts of serum HBV DNA and serum HBeAg levels circulating in CHB patients. The logistic regression model including the PLR and age most accurately distinguished between HBV-CC and HBV-AC patients. The NLR may be useful for follow-up in HBV-CC patients to predict disease progression. In summary, the PLR and NLR provided a supplementary means for effectively managing chronic HBV infection and disease.
本回顾性研究旨在探讨血小板与淋巴细胞比值（PLR）和中性粒细胞与淋巴细胞比值（NLR）与慢性乙型肝炎病毒感染相关肝病（CHB）患者疾病严重程度的关系。
回顾性确定 CHB 患者。从我院电子患者病历系统数据库中收集了 172 例乙型肝炎病毒感染者和 40 名健康对照者的临床资料。
乙型肝炎病毒相关代偿性肝硬化患者（HBV-CC 患者）的平均 PLR 明显低于其他患者（P<0.001）。乙型肝炎病毒相关失代偿性肝硬化患者（HBV-DC 患者）的平均 NLR 明显高于其他任何患者（P<0.001）。在整个 CHB 患者队列中，PLR 与血清 HBV DNA（r=0.264，P<0.001）和血清 HBeAg（r=0.240，P=0.002）呈显著相关。PLR 与 HBV-CC 患者（r=-0.116，P=0.044）和 HBV-DC 患者（r=0.456，P=0.008）的血清 HBV DNA 均呈显著相关。在 HBV 活跃携带者患者（HBV-AC 患者）中，PLR 与血清 HBeAg 水平呈正相关（r=0.321，P=0.023）。在 HBV-DC 患者中，NLR 与血清 HBeAg 水平呈正相关（r=0.372，P=0.033）。在逻辑回归预测模型中，预测概率截断值为 0.392 时，区分 HBV-CC 和 HBV-AC 患者的灵敏度和特异性最高（灵敏度，91.2%；特异性，84.0%）。NLR 截断值为 2.94 时，区分 HBV-DC 和 HBV-CC 患者的灵敏度和特异性最高（灵敏度，81.8%；特异性，88.2%）。
PLR 和 NLR 部分反映了 CHB 患者血清 HBV DNA 和血清 HBeAg 水平的循环量。包括 PLR 和年龄的逻辑回归模型最能准确区分 HBV-CC 和 HBV-AC 患者。NLR 可能有助于对 HBV-CC 患者进行随访，以预测疾病进展。总之，PLR 和 NLR 为有效管理慢性乙型肝炎病毒感染和疾病提供了补充手段。
