Chang Yinghao, Guo Changcun, Guo Guanya, Yuan Zhou, Zhou Xinmin, Wang Jingbo, Han Zheyi, Chen Yu, Jia Gui, Han Ying
Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China.
Department of Gastroenterology and Hepatology, General Hospital of Western Theater Command, Chengdu, Sichuan 610083, P.R. China.
Exp Ther Med. 2020 Mar;19(3):2075-2082. doi: 10.3892/etm.2020.8446. Epub 2020 Jan 13.
Erythroid parameters have been indicated to be important prognostic factors for liver diseases. The present study aimed to evaluate the prognostic value of the erythrocyte count in Chinese patients with primary biliary cholangitis (PBC) and develop a prognostic model. The clinical data of 301 patients with PBC were retrospectively reviewed. Univariate and multivariate Cox regression analysis was performed to identify potential prognostic risk factors. Bivariate correlation analysis was used to determine the correlation coefficient of the erythrocyte count and biochemical indices. The prognostic values of different factors were compared by receiver operating characteristic (ROC) curve analysis. A novel prognostic model was constructed using multivariate logistic regression. Multivariate regression analysis suggested that the erythrocyte count was an independent risk factor/prognostic index (P=0.042). The erythrocyte count in peripheral blood decreased as the histological stage progressed (P<0.001). The erythrocyte count was correlated with albumin, liver stiffness and Fibrosis-4. Compared with that of platelets, the area under the ROC curve of the erythrocyte count was significantly greater. A similar area under the ROC curve was determined for the erythrocyte count, albumin and total bilirubin (P>0.05). A novel prognostic model was established as follows: P=1/{1 + e-[6.140-3.193 × Ln(erythrocyte count) -0.184 × albumin + 0.827 × Ln(total bilirubin)]}. The novel model had a comparable prognostic value to that of the GLOBE score and UK-PBC risk score, and had a better performance than the Mayo risk score at baseline (0.838 vs. 0.787). In conclusion, the erythrocyte count is an independent risk factor/prognostic index in Chinese patients with PBC. It was correlated with liver function and fibrosis in Chinese patients. The novel model incorporating the erythrocyte count and biochemical indices at baseline may serve as a prognostic tool in Chinese patients with PBC (Trial registration number, ChiCTR-ONRC-10002070; date of registration, 2010-05-10).
红细胞参数已被证明是肝脏疾病的重要预后因素。本研究旨在评估红细胞计数在中国原发性胆汁性胆管炎(PBC)患者中的预后价值,并建立一个预后模型。回顾性分析了301例PBC患者的临床资料。进行单因素和多因素Cox回归分析以确定潜在的预后危险因素。采用双变量相关性分析来确定红细胞计数与生化指标的相关系数。通过受试者工作特征(ROC)曲线分析比较不同因素的预后价值。使用多因素逻辑回归构建了一个新的预后模型。多因素回归分析表明,红细胞计数是一个独立的危险因素/预后指标(P = 0.042)。外周血红细胞计数随组织学分期进展而降低(P < 0.001)。红细胞计数与白蛋白、肝脏硬度和Fibrosis-4相关。与血小板相比,红细胞计数的ROC曲线下面积显著更大。红细胞计数、白蛋白和总胆红素的ROC曲线下面积相似(P > 0.05)。建立了如下新的预后模型:P = 1/{1 + e-[6.140 - 3.193 × Ln(红细胞计数) - 0.184 × 白蛋白 + 0.827 × Ln(总胆红素)]}。新模型的预后价值与GLOBE评分和英国PBC风险评分相当,且在基线时比梅奥风险评分表现更好(0.838对0.787)。总之,红细胞计数是中国PBC患者的独立危险因素/预后指标。它与中国患者的肝功能和纤维化相关。纳入基线红细胞计数和生化指标的新模型可作为中国PBC患者的预后工具(试验注册号,ChiCTR-ONRC-10002070;注册日期,2010-05-10)。