红细胞体积分布宽 - 血小板在慢性乙型肝炎比率在肝纤维化

StephenW

Red cell volume distribution width-to-platelet ratio in assessment of liver fibrosis in patients with chronic hepatitis B

    Hye Won Lee1,†, Wonseok Kang1,2,3,†, Beom Kyung Kim1,2,3,‡,*, Seung Up Kim1,2,3,‡,*, Jun Yong Park1,2,3, Do Young Kim1,2,3, Sang Hoon Ahn1,2,3, Young Nyun Park4 andKwang Hyub Han1,2,3

Article first published online: 31 MAY 2015

DOI: 10.1111/liv.12868

© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Issue
Liver International
Liver International

Volume 36, Issue 1, pages 24–30, January 2016

    1    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
    2    Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
    3    Liver Cirrhosis Clinical Research Center, Seoul, Korea
    4    Department of Pathology, Yonsei University College of Medicine, Seoul, Korea

    †    Hye Won Lee and Wonseok Kang contributed equally to this work as joint first authors.
    ‡    Seung Up Kim and Beom Kyung Kim contributed equally to this work as co-corresponding authors.

* Correspondence
Seung Up Kim, MD, PhD, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
Tel: +82 2 2228 1936
Fax: +82 2 393 6884
e-mail: [email protected]

   
Keywords:

    chronic hepatitis B;fibrosis;liver stiffness measurement;red cell volume distribution width-to-platelet ratio

Abstract
Background & Aims

Precise assessment of liver fibrosis is necessary in patients with chronic liver disease. We investigated the performance of red cell volume distribution width-to-platelet ratio for the assessment of liver fibrosis in patients with chronic hepatitis B.
Methods

A total of 482 consecutive patients with chronic hepatitis B who underwent liver biopsy between October 2005 and May 2014 were recruited. Liver stiffness was measured using transient elastography. FIB-4 score, red cell volume distribution width-to-platelet ratio and the aspartate aminotransferase-to-platelet ratio index were also assessed.
Results

A total of 271 (56.2%) patients were males. The median age was 44 years. F1, F2, F3 and F4 fibrosis stages were identified in 68 (14.1%), 137 (28.4%), 64 (13.3%) and 213 (44.2%) of the patients respectively. The mean red cell volume distribution width-to-platelet ratio increased with liver fibrosis severity: F1, 0.065; F2, 0.077; F3, 0.097 and F4, 0.121 (P < 0.01). The area under the receiver operating characteristic curve of the red cell volume distribution width-to-platelet ratio for predicting significant fibrosis (≥F2) was 0.747. This result was inferior to transient elastography (0.866, P = 0.004), but comparable to FIB-4 (0.782, P = 0.427) and aspartate aminotransferase-to-platelet ratio index (0.716, P = 0.507). The area under the receiver operating characteristic curve of red cell volume distribution width-to-platelet ratio for predicting cirrhosis (F4) was 0.811, which was inferior to liver stiffness (0.915, P < 0.001), but comparable to FIB-4 (0.804, P = 0.805) and superior to aspartate aminotransferase-to-platelet ratio index (0.680, P < 0.001).
Conclusions

The accuracy of red cell volume distribution width-to-platelet ratio was acceptable for the assessment of liver fibrosis in patients with chronic hepatitis B. When transient elastography is not available, red cell volume distribution width-to-platelet ratio assessment is a simple method that can be used to reduce the need for liver biopsy.

StephenW

红细胞体积分布宽 - 血小板在慢性乙型肝炎比率在肝纤维化的评价

    惠元Lee1，†，Wonseok Kang1,2,3，†，范庆Kim1,2,3，‡，*，升向上Kim1,2,3，‡，*，君永Park1,2,3，难道年轻Kim1 ，2,3，桑勋Ahn1,2,3，年轻Nyun Park4 andKwang Hyub Han1,2,3

文章首次在网上公布：2015年5月31日

DOI：10.1111 / liv.12868

©2015年约翰·威利父子A / S。由John Wiley＆Sons出版有限公司

问题
肝国际
肝国际

第36卷，第1期，页24-30，2016年一月

    内科，医学延世大学，首尔，韩国1系
    消化内科2研究所，医学延世大学，韩国首尔
    3肝硬化临床研究中心，韩国首尔
    病理4系，医学院，韩国首尔延世大学

    †惠元李和Wonseok康同等贡献这项工作作为共同第一作者。
    ‡升向上Kim和范庆金同等贡献这项工作作为共同通讯作者。

* 对应
升最多金，医学博士，内科，医学延世大学，延世50-1-RO，西大门区，首尔120-752，韩国部
联系电话：+82 2 2228 1936年
传真：+82 2 393 6884
电子邮件：[email protected]

   
关键词：

    慢性乙型肝炎;纤维化;肝脏硬度测量;红细胞体积分布宽度与血小板比率

抽象
背景和目的

肝纤维化的准确的评估是必要的，慢性肝病。我们在慢性乙型肝炎研究红细胞体积分布宽 - 血小板比率表现为肝纤维化的评估
方法

连续入选482例慢性乙型肝炎谁接受2005年10月和2014年5月间的肝活检被招募。使用瞬时弹性成像肝脏硬度测定。 FIB-4评分，红细胞体积分布宽 - 血小板比和天冬氨酸转氨酶对血小板比率指数也进行了评估。
结果

总共有271（56.2％）的患者是男性。平均年龄为44岁。 F1，F2，F3和F4纤维化阶段是在患者68（14.1％），137（28.4％），64（13.3％）和213（44.2％）分别确定。平均红细胞体积分布宽度对血小板的比例增加，肝纤维化程度：F1，0.065; F2，0.077; F3，0.097和F4，0.121（P <0.01）。接收机操作所述红细胞体积分布宽 - 血小板比率的特性曲线预测显著纤维化（≥F2）下面积为0.747。该结果不如瞬时弹性（0.866，P = 0.004），但可比FIB-4（0.782，P = 0.427）和天冬氨酸氨基转移酶对血小板比率指数（0.716，P = 0.507）。接收机下操作红细胞体积分布宽 - 血小板比率的特性曲线，用于预测性肝硬化（F4）的面积为0.811，这是劣于肝脏硬度（0.915，P <0.001），但可比FIB-4（0.804 P = 0.805），并优于天冬氨酸转氨酶对血小板比率指数（0.680，P <0.001）。
结论

红细胞体积分布宽 - 血小板比率的准确性是可以接受的肝纤维化的慢性乙型肝炎的评估当瞬时弹性不可用，红细胞体积分布宽 - 血小板比率评估是一个简单的方法可用于减少需要进行肝活检。