Abant Izzet Baysal University Hospital, Department of Internal Medicine - Bolu, Turkey.
Rev Assoc Med Bras (1992). 2022 Jun 24;68(6):838-841. doi: 10.1590/1806-9282.20220236. eCollection 2022.
Chronic hepatitis C (CHC) is one of the most important health problems affecting the significant rate of world population and it may lead to cirrhosis and hepatocellular carcinoma. C-reactive protein to lymphocyte count ratio (CLR) is used in estimating inflammatory burden. Therefore, this study aimed to compare CLR values between CHC patients and healthy controls and between CHC patients with and without fibrosis.
Patients with CHC infection who visited outpatient and inpatient internal medicine clinics of our institution between January 2021 and December 2021 were enrolled to this retrospective study. CLR of the patients with CHC and healthy controls were compared. We further compared CLR of CHC patients with and without fibrosis.
Median CLR of CHC and control subjects was 2.61 (5.13%) and 0.31 (0.37%), respectively. CLR of the CHC group was significantly increased compared to the CLR of the controls (p<0.001). There was a significant positive correlation between CLR and APRI score (r=0.15, p=0.04). The sensitivity and specificity of CLR in determining CHC above 0.58% level were 84% and 82%, respectively (AUC: 0.884, p<0.001, 95%CI 0.84-0.93). In subgroup analysis, CLR was 3.97 (6.6%) for CHC patients with fibrosis and 1.7 (4.4%) for CHC subjects without fibrosis (p=0.001).
Increased CLR in patients with CHC may be an alarming finding of liver fibrosis, as CLR is associated with both CHC and hepatic fibrosis.
慢性丙型肝炎（CHC）是影响世界人口重大比例的最重要健康问题之一，它可能导致肝硬化和肝细胞癌。C 反应蛋白与淋巴细胞计数比值（CLR）用于估计炎症负担。因此，本研究旨在比较 CHC 患者与健康对照组以及 CHC 患者有无纤维化之间的 CLR 值。
本回顾性研究纳入了 2021 年 1 月至 2021 年 12 月期间我院门诊和住院内科就诊的 CHC 感染患者。比较 CHC 患者和健康对照者的 CLR。我们进一步比较了有和无纤维化的 CHC 患者的 CLR。
CHC 和对照组的中位 CLR 分别为 2.61（5.13%）和 0.31（0.37%）。CHC 组的 CLR 明显高于对照组（p<0.001）。CLR 与 APRI 评分呈显著正相关（r=0.15，p=0.04）。CLR 用于确定 CHC 水平高于 0.58%的敏感性和特异性分别为 84%和 82%（AUC：0.884，p<0.001，95%CI 0.84-0.93）。在亚组分析中，纤维化的 CHC 患者的 CLR 为 3.97（6.6%），无纤维化的 CHC 患者的 CLR 为 1.7（4.4%）（p=0.001）。
CHC 患者的 CLR 升高可能是肝纤维化的一个警示发现，因为 CLR 与 CHC 和肝纤维化均有关。
