红细胞分布宽度与血小板比值对肝纤维化的预测价值。

StephenW

Scand J Gastroenterol. 2019 Jan 20:1-6. doi: 10.1080/00365521.2018.1558786. [Epub ahead of print]
Predictive value of the red blood cell distribution width-to-platelet ratio for hepatic fibrosis.
Yuyun D1, Zhihua T2, Haijun W3, Zhaoping L4, Xiaoli Z5, Wenfang X6, Faxiang J6, Hongmei L6.
Author information

1
    a Department of Laboratory Medicine , The Affiliated Hospital of Shaoxing University , Shaoxing , China.
2
    b Department of Laboratory Medicine , The Second Affiliated Hospital of Zhejiang University School of Medicine Laboratory Medicine , Hangzhou , China.
3
    c Department of Pathology , The Second Affiliated Hospital of Zhejiang University School of Medicine , Hangzhou , China.
4
    d Department of Blood transfusion , The Second Affiliated Hospital of Zhejiang University School of Medicine , Hangzhou , China.
5
    e Department of Laboratory Medicine , Taizhou Hospital of Zhejiang Province , Linhai City , China.
6
    f Department of Laboratory Medicine , The Affiliated Hospital of Shaoxing University , Shaoxing , China.

Abstract
AIMS:

The red blood cell distribution width-to-platelet ratio (RPR) has been reported to be an indicator of hepatic fibrosis in patients with chronic hepatitis B (HBV), nonalcoholic fatty liver disease (NAFLD) or chronic hepatitis C (HCV). However, no research has explored the RPR in all patients with hepatic fibrosis. There is a recognized need to establish whether the RPR could assess hepatic fibrosis and reflect the severity of fibrosis, regardless of the patient's etiology.
METHODS:

Quantitative data from 1282 patients who underwent liver biopsy between January 2010 and December 2014 at the Second Affiliated Hospital of Zhejiang University School of Medicine were included. The etiologies included HBV or HCV infection, NAFLD, schistosomiasis, granulomatous liver disease, and vascular abnormalities. Five noninvasive models were calculated for all patients based on laboratory parameters. The degrees of fibrosis severity were evaluated based on the Metavir scoring scale.
RESULTS:

The RPR demonstrated the best accuracy of predicting hepatic fibrosis among the selected five models (0.75, p < .001) regardless of etiology. In addition, the RPR values increased with advanced hepatic fibrosis progression. Furthermore, combining the RPR with the white blood cell (WBC) count improved the accuracy of grading hepatic fibrosis as reflected by the likelihood ratio (LR + 9.03, LR - 0.49).
CONCLUSION:

The RPR is a useful indicator for hepatic fibrosis, regardless of etiology, and can reflect the severity of fibrosis. This study supports further clinical development of the RPR both in a stepwise manner or in combination with inflammatory parameters to improve the accuracy of scoring hepatic fibrosis.
KEYWORDS:

PLT; RDW; RPR; WBC; hepatic fibrosis; noninvasive

PMID:
    30663454
DOI:
    10.1080/00365521.2018.1558786

StephenW

Scand J Gastroenterol。 2019年1月20日：1-6。 doi：10.1080 / 00365521.2018.1558786。 [印刷前的电子版]
红细胞分布宽度与血小板比值对肝纤维化的预测价值。
Yuyun D1，Zhihua T2，Haijun W3，Zhaoping L4，Xiaoli Z5，Wenfang X6，Faxiang J6，Hongmei L6。
作者信息

1
    绍兴文理学院附属医院检验科，绍兴
2
    b浙江大学医学院附属第二医院检验医学科，杭州，中国。
3
    c浙江大学医学院附属第二医院病理科，杭州，中国。
4
    d浙江大学医学院附属第二医院输血科，杭州，中国。
五
    e浙江省台州市医院检验科，临海市
6
    f绍兴文理学院附属医院检验科，绍兴

抽象
目的：

据报道，红细胞分布宽度与血小板比（RPR）是慢性乙型肝炎（HBV），非酒精性脂肪性肝病（NAFLD）或慢性丙型肝炎（HCV）患者肝纤维化的指标。然而，没有研究探讨所有肝纤维化患者的RPR。无论患者的病因如何，人们都认识到需要确定RPR是否可以评估肝纤维化并反映纤维化的严重程度。
方法：

2010年1月至2014年12月在浙江大学医学院附属第二医院接受肝活检的1282例患者的定量数据被包括在内。病因包括HBV或HCV感染，NAFLD，血吸虫病，肉芽肿性肝病和血管异常。根据实验室参数计算了所有患者的五种非侵入性模型。基于Metavir评分量表评估纤维化严重程度。
结果：

无论病因如何，RPR都显示出在所选择的五个模型中预测肝纤维化的最佳准确性（0.75，p <.001）。此外，RPR值随着晚期肝纤维化进展而增加。此外，结合RPR与白细胞（WBC）计数提高了肝纤维化分级的准确性，如似然比（LR + 9.03，LR-0.49）所反映的。
结论：

无论病因如何，RPR都是肝纤维化的有用指标，可反映纤维化的严重程度。该研究以逐步方式或与炎性参数组合支持RPR的进一步临床开发，以提高肝纤维化评分的准确性。
关键词：

PLT; RDW; RPR; WBC;肝纤维化;无创

结论：
    30663454
DOI：
    10.1080 / 00365521.2018.1558786