慢性HBV感染者血脂和白蛋白-胆红素指数与疾病进展的关系

目的探讨血脂相关指标及白蛋白-胆红素指数(ALBI指数)对慢性HBV感染后疾病进展的评估价值。方法选取2016年6月-2017年6月在安徽医科大学第二附属医院就诊的184例慢性HBV感染者,将其根据不同的疾病阶段分为HBV携带者74例(ASC组),慢性乙型肝炎患者70例(CHB组),代偿期肝硬化患者40例(LC组),并以50例健康对照者作为对照(HC组)。检测血脂相关指标和肝功能指标,分析血脂指标与ALBI指数在慢性HBV感染后疾病进展中的变化特点。计量资料多组间比较采用单因素方差分析,进一步两两比较采用Dunnett法;计数资料组间比较采用χ2检验;相关性分析采用Pearson相关分析法。结果 ASC组、CHB组、LC组、HC组间血脂指标CHO、HDL-C、LDL-C、APOA、APOB差异均有统计学意义(F值分别为12. 075、19. 559、6. 554、9. 392、5. 458,P值均<0. 001);与其他3组比较,LC组以上指标降低最为显著,组间差异均有统计学意义(P值均<0. 05)。ALBI指数在4组间差异有统计学意义(F=49. 225,P <0. 001),进一步比较显示,LC组ALBI指数最高,与其他3组比较差异均有统计学意义(P值均<0. 05),ASC组和CHB组ALBI指数亦显著高于HC组(P值均<0. 05)。CHO、HDL-C、LDL-C、APOA与ALBI指数均呈负相关(P值均<0. 05),其中以CHO、HDL-C与ALBI指数相关性最强(r值分别为-0. 310、-0. 266,P值均<0. 001)。结论慢性HBV感染者血脂相关指标和ALBI指数有助于反映肝脏功能损伤程度,在肝硬化患者中尤其明显。

Association of blood lipids and albumin-bilirubin index with disease progression in patients with chronic hepatitis B virus infection

ObjectiveTo investigate the value of blood lipid indices and albumin-bilirubin index (ALBI) in evaluating the progression of chronic hepatitis B virus (HBV) infection. MethodsA total of 184 patients with chronic HBV infection who visited The Second Affiliated Hospital of Anhui Medical University from June 2016 to June 2017 were enrolled, and according to the stage of the disease, they were divided into ASC group (74 HBV carriers), CHB group (70 patients with chronic hepatitis B), and LC group (40 patients with compensated cirrhosis). A total of 50 healthy individuals were enrolled as health control (HC) group. Blood lipid indices and liver function parameters were measured, and the changes in blood lipid indices and ALBI during the progression of chronic HBV infection were analyzed. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the Dunnett method was used for further comparison between two groups;the chi-square test was used for comparison of categorical data between groups;Pearson correlation analysis was used to investigate correlation. Results There were significant differences between the ASC, CHB, LC, and HC groups in blood lipid indices of cholesterol (CHO), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A (APOA), and apolipoprotein B ( F =12.075, 19.559, 6.554, 9.392, and 5.458, all P <0.001), and the LC group had significantly greater reductions in the above indices compared with the other three groups (all P <0.05). There was a significant difference in ALBI between the four groups ( F=49.225, P <0.001);the LC group had a significantly higher ALBI than the other three groups (all P <0.05), and the ASC and CHB groups had a significantly higher ALBI than the HC group (both P <0.05). CHO, HDL-C, LDL-C, and APOA were negatively correlated with ALBI (all P <0.05), among which CHO and HDL-C had the strongest correlation with ALBI ( r=-0.310 and -0.266, both P <0.001). ConclusionIn patients with chronic HBV infection, blood lipid indices and ALBI can reflect the degree of liver function damage, especially in patients with liver cirrhosis.