Zhao Tian-Yu, Cong Qing-Wei, Liu Fang, Yao Li-Ying, Zhu Ying
Liver Disease Center of Integrated Traditional Chinese and Western Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
Front Pharmacol. 2021 Sep 20;12:755625. doi: 10.3389/fphar.2021.755625. eCollection 2021.
Mean corpuscular volume (MCV) is major used as an indicator for the differential diagnosis of anemia. Macrocytic anemia in decompensated cirrhosis is common. However, the relationship between macrocytic anemia and decompensated hepatitis B virus (HBV) associated cirrhosis has not been fully addressed. In this cross-sectional study, a total of 457 patients diagnosed decompensated HBV associated cirrhosis who met all inclusion criteria from 2011 to 2018 were analyzed. Association between macrocytic anemia and the liver damaged (Model for End Stage Liver Disease (MELD) score) were examined using multiple logistic regression analyses and identified using smooth curve fitting. Compared with normocytic anemia, MCV and MELD are significantly positively correlated in macrocytic anemia ( < 0.001). A non-linear relationship of MCV and MELD association was found though the piecewise linear spline models in patients with decompensated HBV associated cirrhosis. MCV positive correlated with MELD when the MCV was greater than 98.2 fl (regression coefficient = 0.008, 95% CI 0.1, 0.4). Macrocytic anemia may be a reliable predictor for mortality because it is closely related to the degree of liver damage in patients with decompensated HBV associated cirrhosis.
平均红细胞体积（MCV）主要用作贫血鉴别诊断的指标。失代偿期肝硬化中的大细胞性贫血很常见。然而，大细胞性贫血与失代偿期乙型肝炎病毒（HBV）相关性肝硬化之间的关系尚未得到充分探讨。在这项横断面研究中，分析了2011年至2018年期间共457例符合所有纳入标准的诊断为失代偿期HBV相关性肝硬化的患者。使用多元逻辑回归分析检验大细胞性贫血与肝损伤（终末期肝病模型（MELD）评分）之间的关联，并通过平滑曲线拟合进行识别。与正常细胞性贫血相比，大细胞性贫血中MCV与MELD显著正相关（<0.001）。通过失代偿期HBV相关性肝硬化患者的分段线性样条模型发现MCV与MELD关联存在非线性关系。当MCV大于98.2 fl时，MCV与MELD呈正相关（回归系数 = 0.008，95%CI 0.1，0.4）。大细胞性贫血可能是死亡率的可靠预测指标，因为它与失代偿期HBV相关性肝硬化患者的肝损伤程度密切相关。
