血小板参数对慢性乙型肝炎肝硬化及肝功能评估的临床价值研究

目的 探讨血小板参数对慢性乙型肝炎（简称乙肝）肝硬化及肝功能评估的临床价值.方法 选择乙肝肝硬化患者167例（肝硬化组）,根据Child-Pugh评分标准进行肝功能分级：A级48例（A级组）,B级65例（B级组）,C级54例（C级组）.选择同期健康体检者50例作为对照组,比较乙肝肝硬化各肝功能分级组与对照组的血小板计数（PLT）、血小板分布宽度（PDW）、血小板平均体积（MPV）,并对上述指标进行相关性分析.结果 肝硬化组PLT、MPV、PDW分别为（88.53±21.36）×109/L、（9.47±2.02） fl、（12.41±1.16） fl,对照组分别为（172.64±37.42）×109/L、（11.47±2.16）fl、（10.49±0.83） fl,肝硬化组PLT、MPV较对照组显著降低,PDW显著增加,差异均有统计学意义（P＜0.01）.A级组、B级组、C级组PLT [（123.78 ±26.35）×109/L、（84.96±31.62）×109/L、（61.48±27.13）×109/L]均显著低于对照组,差异有统计学意义（P＜0.01）;A级组与对照组MPV、PDW比较差异无统计学意义（P＞0.05）;B级组、C级组MPV、PDW与对照组比较差异有统计学意义[（9.68±2.23）、（8.65±2.19）fl比（11.47 ±2.16） fl和（12.26± 1.35）、（14.13±1.54） fl比（10.49±0.83） fl]（P＜ 0.05或＜0.01）.相关性分析结果显示PLT、MPV与肝功能分级呈显著正相关（r=0.365、0.473,P＜ 0.05）.而PDW与肝功能分级呈显著负相关（r=-0.512,P＜ 0.05）.结论 PLT、MPV、PDW可以作为评价乙肝肝硬化时肝功能分级指标,动态观察各参数变化规律,对乙肝肝硬化的病情评估及治疗具有重要临床意义.

Clinical value of platelet parameters for the assessment of liver function in chronic hepatitis B liver cirrhosis

Objective To investigate the clinical value of platelet parameters for the assessment of liver function in chronic hepatitis B （CHB） liver cirrhosis.Methods A total of 167 patients with CHB liver cirrhosis （CHB liver cirrhosis group） were selected,according to Child-Pugh score of liver function classification：A grade 48 cases （A grade group）,B grade 65 cases （B grade group）,C grade 54 cases （C grade group）.Fifty healthy cases were chosen as control group,then compared blood platelet count （PLT）,platelet distribution width （PDW）,mean platelet volume （MPV） levels differences between every group,and these indicators were analyzed.Results PLT,MPV,PDW was（88.53 ± 21.36） × 109/L,（9.47 ± 2.02） fl,（12.41 ± 1.16） fl in CHB liver cirrhosis group,and （172.64 ± 37.42） × 109/L,（11.47 ± 2.16） fl,（10.49 ±0.83） fl in control group,and PLT,MPV were significantly reduced （P ＜0.01）,and PDW increased significantly in CHB liver cirrhosis group compared with control group （P＜ 0.01）.PLT in A,B,C grade group [（123.78 ± 26.35） × 109/L,（84.96 ± 31.62） × 109/L,（61.48 ± 27.13） × 109/L] was lower than that in control group,and there was significant difference （P＜ 0.01）.There was no significant difference in MPV,PDW between A grade group and control group （P ＞0.05）.There was no significant difference in MPV,PDW between B grade,C grade group and control group [（9.68 ±2.23）,（8.65 ±2.19） fl vs.（11.47 ±2.16） fl and （12.26 ± 1.35）,（14.13 ± 1.54） fl vs.（10.49 ±0.83） fl]（P＜0.05 or ＜0.01）.Correlation analysis showed that PLT,MPV was positively correlated with liver function （r =0.365,0.473,P ＜0.05）.But PDW was nagtively correlated with liver function （r =-0.512,P ＜0.05）.Conclusions Platelet parameters such as PLT,MPV,PDW are good to evaluate the liver function and it＇s compensatory of CHB liver cirrhosis,and that dynamic changes of the parameters has important clinical significance in the disease assessment and treatment of liver cirrhosis.