Application Of Platelet Parameters In Chronic Hepatitis B Liver Fibrosis

Objective: In this study,the differences of platelet-related parameters in different hepatic fibrosis groups of chronic HBV patients were analyzed to explore the application value of platelet-related parameters in patients with chronic HBV liver fibrosis,and the prediction efficacy of different platelet parameters on the degree of liver fibrosis was compared.Methods: A total of 391 subjects were collected in this study,including 291 patients with chronic hepatitis B and 100 healthy control group who underwent liver biopsy in a Grade-A hospital.By analyzing age,gender and platelet related parameters in chronic HBV patients and healthy control group,the data included: Mean platelet volume(MPV),platelet distribution width(PDW),platelet count(PLT),large platelet ratio(P-LCR),platelet volume(PCT),mean platelet volume/platelet ratio(MPR),aspartate aminotransferase/platelet ratio(APRI),FIB-4 index,Platelet distribution width/mean platelet volume ratio(PDW/MPV),platelet distribution width/platelet count ratio(PDW/PLT),and liver function(AST,ALT,GGT,ALP)levels were compared to see whether there were statistical differences in the above indexes among the two groups.Chronic HBV patients were divided into non-fibrosis group(S0),mild fibrosis group(S1)and significant fibrosis group(S2-S4).We compared age,gender,platelet-related parameters,hepatic fibrosis(type Ⅳ collagen(CIV),type Ⅲprocollagen(PIIIP),hyaluronase(HA)and laminin(LN))and liver function among the three groups.ROC curve was used to evaluate the predictive power of platelet-related parameters to significant fibrosis in chronic HBV patients and to calculate the truncation values of related parameters.Results: 1.There were no significant differences in sex,age,GGT and ALP between chronic HBV patients and healthy controls(P<0.05).The levels of PLT,PCT,APRI and FIB-4 in chronic HBV patients were lower than those in the control group,while the indexes of MPV,PDW,P-LCR,AST,ALT and MPR were higher than those in the control group,with statistical significance.(P < 0.05).2.There were no significant differences in gender,MPV,ALP,PIIIP,HA and LN among the three groups of chronic HBV patients(P > 0.05).The levels of age,PLT,PCT,PDW,ALT,P-LCR,AST,GGT and PDW/PLT,APRI,FIB-4,MPR and PDW/MPV were different in different stages of fibrosis.There were no significant differences in PIIIP,HA,LN and CIV among the four indexes of hepatic fibrosis,and the CIV of the significant group was higher than that of the non-fibrosis group and the mild fibrosis group(P<0.05).3.AST(OR=1.016,95%CI1.005-1.027,P<0.05),PLT(OR=0.990,95%CI0.984-0.996,P<0.05)was an influential factor in the diagnosis of significant fibrosis.4.Compared the area under the curve of APRI,FIB-4,MPR,PDW/MPV,and PDW/PLT for the diagnosis of significant fibrosis,FIB-4 had a higher diagnostic efficacy(AUC=0.672,95% CI0.615-0.726,P=0.000).The sensitivity of MPR was the best,and the specificity of PDW/MPV was better.The area under the curve of combined diagnosis was higher than that of significant fibrosis diagnosed by single indicator.(P< 0.05)Conclusion: Patients with chronic HBV have abnormal platelet parameters,which are related to fibrosis stage progression.PLT and AST are influential factors of significant liver fibrosis.ROC curve verifies the value of APRI,FIB-4,MPR,PDW/MPV and PDW/PLT in determining significant fibrosis.Detection of platelet parameter levels in peripheral blood of chronic HBV patients in clinical work may be of important clinical value for observing patients’ condition,early treatment,active response to recurrence and improvement of prognosis.