慢性乙型肝炎者外周血SAA/CRP、NLR水平与HBV-DNA载量、病情程度的相关性分析OACSTPCD

Objective To investigate the correlation and clinical significance of peripheral blood serum amyloid A(SAA)to C-reactive protein(CRP)ratio(SAA/CRP),neutrophils lymphocytes ratio(NLR)and HBV-DNA levels and disease severity in patients with chronic hepatitis B(CHB),so as to find out the correlation between SAA and CRP(SAA/CRP),neutrophils lymphocytes ratio(NLR)and hepatitis B virus-deoxyribonucleic acid(HBV-DNA).Methods From June 2020 to June 2022,100 patients with CHB in our hospital were selected as the study subject and were divided into the mild group(simple CHB,36 cases),the moderate group(cirrhosis in the compensated stage of hepatitis B,33 cases)and the severe group(cirrhosis in the decompensated stage of hepatitis B,31 cases)according to the degree of disease.And at the same time,another 50 healthy volunteers with the same age were selected as the control group.Different disease degrees,general information,serum SAA/CRP and NLR levels in the control group,and serum SAA/CRP and NLR levels in patients with different HBV-DNA loads in the study group were compared respectivly and the correlation between the serum SAA/CRP and NLR levels in patients with CHB and HBV-DNA loads and disease degrees were analyzed.The correlation between the serum SAA/CRP,NLR levels and HBV-DNA load and the degree of disease in CHB patients was analyzed.All patients were treated with the antiviral therapy for 24 weeks,and serum SAA/CRP,NLR levels and the change values of patients with different antiviral efficacies were compared before the treatment and 12 weeks and 24 weeks after the treatment and the value of the change values of serum SAA/CRP,NLR levels before and after the treatment was analyzed so as to predict the efficacy of the therapy.Results Serum SAA/CRP and NLR levels in severe patients>moderate patients>mild patients>control group(P<0.05);serum SAA/CRP and NLR levels in high carrier patients>moderate carrier patients>mild carrier patients(P<0.05);serum SAA/CRP and NLR levels in CHB patients were positively correlated with HBV-DNA load(r=0.756,0.709),and disease extent(r=0.776,0.745)were positively correlated(P<0.05);The levels of peripheral blood SAA/CRP and NLR at 12 and 24 weeks after the treatment were higher in non-responders than in responders,and the change values were lower than in responders(P<0.05);the AUCs predicted by SAA/CRP∆1 and NLR∆1 alone were 0.752,0.773 for SAA/CRP△1 and NLR△1 alone,and 0.861 for combined prediction of △1;the AUCs for SAA/CRP△2 and NLR△2 alone were 0.796 and 0.819,respectively,and 0.967 for combined prediction of △2,which were greater than those for combined prediction of △1(P<0.05).Conclusion SAA/CRP and NLR are significantly correlated with HBV-DNA load and disease extent in CHB,and the changes in their levels can be used clinically to assess the disease and predict the prognosis,so as to target the follow-up treatment and improve the prognosis.