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[1]邓宝茹,周璐,孙超,等.无创血清学指标对原发性胆汁性胆管炎组织病理学分期的诊断价值[J].天津医科大学学报,2017,23(04):340-342.
　DENG Bao-ru,ZHOU Lu,SUN Chao,et al.Diagnostic value of? non-invasive serological markers in? histopathological staging of primary biliary cholangitis[J].Journal of Tianjin Medical University,2017,23(04):340-342.
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无创血清学指标对原发性胆汁性胆管炎组织病理学分期的诊断价值(PDF)

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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:: 23卷
期数:: 2017年04期

页码:: 340-342

栏目:: 临床医学

出版日期:: 2017-07-02

文章信息/Info

Title:: Diagnostic value of? non-invasive serological markers in? histopathological staging of primary biliary cholangitis

文章编号:: 1006-8147(2017)04-0340-03

作者:: 邓宝茹; 周璐; 孙超; 王邦茂; （天津医科大学总医院消化内科，天津 300052）

Author(s):: DENG Bao-ru; ZHOU Lu; SUN Chao; WANG Bang-mao; (Department of Gastroenterology and Hepatology,General Hospital, Tianjin Medical University, Tianjin 300052,China)

关键词:: 原发性胆汁性胆管炎; 红细胞体积分布宽度; 红细胞体积分布宽度与血小板计数比值; 病理分期

Keywords:: primary biliary cholangitis??; red blood cell distribution width; RDW to platelet ratio; pathological stage

分类号:: R575.7

DOI:: -

文献标志码:: A

摘要:: 目的：探讨红细胞体积分布宽度（RDW）与血小板计数比值（RPR）对原发性胆汁性胆管炎（PBC）病理分期严重程度的诊断价值。方法：收集行肝穿刺活检的初诊未经治PBC患者77例，肝活检标本依据Scheuer分期分为早期（1&2期）或进展期（3&4期）。同时检测患者外周血包括RDW，血小板计数、ALT、AST等生化指标，并计算RPR、APRI、AAR和FIB-4。采用Spearman相关性分析评价不同参数之间的关系，通过受试者工作特征曲线下面积（AUC）判断各项指标和模型对PBC患者肝脏病理分期的诊断价值。结果：77例行肝穿刺活检患者中24例（31.2%）确诊为早期病理学改变，53例（68.8%）为进展期病理学改变。病理提示进展期特征的患者RDW、RPR、FIB-4分别为15.5%、0.15和6.34，均显著高于肝穿提示早期病理学改变患者的14.1%（P=0.016）、0.09（P<0.001）和3.41（P=0.001）。RPR诊断病理分期的AUC最高为0.74（P<0.001），其次为FIB-4（0.73，P=0.002），RDW（0.67，P=0.017）和AAR（0.67，P=0.018），APRI的AUROC为0.61，差异无统计学意义（P=0.13）。RPR、FIB-4、RDW和AAR的最佳诊断界值分别为0.14、4.19、14.3%和1.09，敏感性分别为49.1%、56.6%、62.3%和69.8%，特异性分别为95.8%、83.3%、66.7%和70.8%。结论：RPR、RDW能够协助区分PBC患者肝脏病理的早期和进展期改变，其诊断价值优于APRI或AAR，可作为一种简单、便宜且易获取的临床筛选参考指标。

Abstract:: Objective: To investigate the diagnostic accuracy of red blood cell distribution width (RDW), RDW to platelet ratio (RPR) in the assessment of histological severity in patients with primary biliary cirrhosis (PBC). Methods: The clinical data and histological results from 77 consecutive PBC patients who underwent liver biopsywere collected. The pathological stages were divided to early stage and late stage according to Scheuer criteria. The laboratory results were also obtained and used for the calculation of RPR, APRI, AAR and FIB-4. The association of chemical indices was acquired using Spearman correlation test, while the diagnostic accuracy for each parameter was compared by the area under receiver operating curve (AUC). Results: Twenty-four patients (31.2%) were classified as early stage, while 53 cases (68.8%) as late stage. Patients with late stage exhibited significantly higher RDW, RPR and FIB-4 in comparison to those with early stage. The AUC of RPR was highest among all investigated measurements. The cut-off value, sensitivity, specificity and likelihood of RPR were 0.14, 49.1%, 95.8% and 11.8, respectively. Conclusion: RPR may serve as an affordable and accessible index in the assessment of histological severity in PBC patients, and its practical utility is superior to APRI.