肝纤维化指标、外周血常规指标和GPR对重度慢性乙型肝炎的诊断价值及其相关性分析OACSTPCD

Objective To evaluate the diagnostic value and correlation of liver fibrosis markers[hyaluronic acid(HA),laminin(LN),procollagen type Ⅲ amino acid terminal peptide(PⅢ NP)and type Ⅳ collagen(ⅣC)],peripheral blood routine indicators[red blood cell volume distribution width(RDW),white blood cell count(WBC),lymphocyte count(LY),mean platelet volume(MPV)and platelet count(PLT)],y-glutamyl-transferase(GGT)to PLT ratio(GPR)in the diagnosis of chronic hepatitis B.Methods A total of 120 pa-tients with severe chronic hepatitis B admitted to the hospital from January 2022 to June 2023 were selected as the observation group.According to the Child-Pugh liver function classification,they were divided into grade A,B and C,and 100 healthy subjects were selected as the control group.Fasting venous blood of 5 mL was col-lected from the two groups in the morning,and the liver fibrosis indicators were detected by radioimmunoas-say.Peripheral blood routine indicators were detected by automatic blood cell analyzer with rate method,GGT was detected by rate method using automatic biochemical analyzer,and GPR was calculated.The receiver oper-ating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the diagnostic value of liver fibrosis indicators,peripheral blood routine indicators and GPR for severe chronic hepatitis B,and the correlation between each indicator was analyzed.Results The levels of HA,LN,P Ⅲ NP and ⅣC in the observation group were significantly higher than those in the control group,and the worse the liver function,the higher the levels of HA,LN,PⅢ NP and ⅣC,grade A＜grade B＜grade C,the differences were statistically significant(P＜0.05).The WBC and PLT in the observation group were lower than those in the control group,and the PLT in grade A and grade B were higher than those in grade C,the differences were statistically significant(P＜0.05).The RDW,MPV and GPR in the observation group were higher than those in the control group,and grade A＜grade B＜grade C,the differences were statistically significant(P＜0.05).ROC curve analysis showed that the sensitivity and specificity of liver fibrosis index,peripheral blood routine indicators and GPR in the diagnosis of severe chronic hepatitis B were high,and the AUC were 0.985,0.892 and 0.773 respectively.WBC,LY and PLT were negatively correlated with liver fibrosis indicators(P＜0.05),and RDW and MPV were positively correlated with liver fibrosis indicators(P＜0.05).GPR was posi-tively correlated with liver fibrosis indicators(P＜0.05).WBC,LY and PLT were negatively correlated with GPR(P＜0.05).RDW and MPV were positively correlated with GPR(P＜0.05).Conclusion Liver fibrosis index,peripheral blood routine indicators and GPR have high diagnostic value for severe chronic hepatitis B.The changes of WBC,RDW,LY,MPV,PLT and GPR can be used to judge the degree of liver fibrosis in chro-nic hepatitis B.