红细胞分布宽度对血小板比值在预测慢性乙型肝炎肝纤维化

StephenW

Mymensingh Med J. 2018 Jul;27(3):550-560.
Role of Red Cell Distribution Width to Platelet Ratio in Predicting Hepatic Fibrosis in Chronic Hepatitis B.
Ferdous A1, Ahmed AN, Rahman SA, Hasan T, Mahzabeen L.
Author information

1
    Dr Afroza Ferdous, Assistant Surgeon, Narayanganj Sadar Upazilla Health Complex, Narayanganj, Bangladesh.

Abstract

Hepatitis B virus (HBV) infection is a serious global health problem. Globally more than 2 (Two) billion people are infected with Hepatitis B virus and about 400 million people are chronic carriers who are at risk of death from liver cirrhosis and liver cancer that kill more than one million people globally each year. Prevalence of HBV infection in Bangladesh is 2.3 to 9.7% and approximately 10 million people are harboring the virus as carrier. HBV infection is increasing at an alarming rate in Bangladesh due to lack of health education, poverty, illiteracy and lack of hepatitis B vaccination. This cross sectional study was carried out in the Department of Clinical Pathology, in collaboration with Department of Hepatology and Department of Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2013 to August 2014 to assess the role of Red cell distribution width to platelet ratio (RPR) as a non invasive marker in predicting hepatic fibrosis in chronic hepatitis B patients. Total 40 patients with chronic hepatitis B virus infection who fulfilled the criteria of chronic hepatitis B were included in this study. In this study, majority of the patients belonged to 20-29 years, most of the patients were male and HBeAg negative .Histopathology was gold standard to identify the stages of hepatic fibrosis. We also measured RDW and Platelet count by automated haematology analyzer when platelet count was rechecked manually; RDW to platelet ratio was calculated to see the correlation between RPR with different stages of hepatic fibrosis. In chronic hepatitis B patients a positive and significant correlation was found between RPR and stages of hepatic fibrosis and Spearman's correlation coefficient for RPR was 0.749 which was positive and highly significant (p<0.001). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of RDW to Platelet ratio (RPR) was 62.86%, 80%, 95.65%, 23.53% and 65% respectively. To assess the diagnostic performance of RPR we also used receiver-operating curve (ROC). The area under ROC was 0.889 for identification of hepatic fibrosis. This data revealed that RPR is strongly associated with stages of hepatic fibrosis in chronic hepatitis B patients. As such RPR may be a useful diagnostic tool for assessing the hepatic fibrosis in chronic hepatitis B patients.

PMID:
    30141445

StephenW

Mymensingh Med J. 2018 Jul; 27（3）：550-560。
红细胞分布宽度对血小板比值在预测慢性乙型肝炎肝纤维化中的作用
Ferdous A1，Ahmed AN，Rahman SA，Hasan T，Mahzabeen L.
作者信息

1
    Afroza Ferdous博士，孟加拉国Narayanganj的Narayanganj Sadar Upazilla健康中心助理外科医生。

抽象

乙型肝炎病毒（HBV）感染是一个严重的全球健康问题。全球超过2（2）亿人感染乙型肝炎病毒，约4亿人是慢性携带者，他们有肝硬化和肝癌死亡的风险，每年全球有超过100万人死亡。孟加拉国HBV感染率为2.3％至9.7％，约有1000万人携带该病毒作为携带者。由于缺乏健康教育，贫困，文盲和缺乏乙型肝炎疫苗接种，孟加拉国的HBV感染率正以惊人的速度增长。这项横断面研究于2013年9月至2014年8月在孟加拉国达卡Bangabandhu Sheikh Mujib医科大学（BSMMU）与肝病学系和病理学系合作进行，以评估红细胞的作用。分布宽度与血小板比值（RPR）作为预测慢性乙型肝炎患者肝纤维化的非侵入性标志物。共有40名符合慢性乙型肝炎标准的慢性乙型肝炎病毒感染患者被纳入本研究。在这项研究中，大多数患者属于20-29岁，大多数患者为男性和HBeAg阴性。病理学是确定肝纤维化分期的金标准。当手动重新检查血小板计数时，我们还通过自动血液分析仪测量RDW和血小板计数;计算RDW与血小板比率以观察RPR与肝纤维化的不同阶段之间的相关性。在慢性乙型肝炎患者中，RPR与肝纤维化分期之间存在正相关和显着相关，RAR的Spearman相关系数为0.749，呈阳性且非常显着（p <0.001）。 RDW对血小板比值（RPR）的敏感性，特异性，阳性预测值，阴性预测值和准确性分别为62.86％，80％，95.65％，23.53％和65％。为了评估RPR的诊断性能，我们还使用了接收器操作曲线（ROC）。用于鉴定肝纤维化的ROC下面积为0.889。该数据显示RPR与慢性乙型肝炎患者的肝纤维化阶段密切相关。因此，RPR可能是评估慢性乙型肝炎患者肝纤维化的有用诊断工具。

结论：
    30141445