A Correlation Study On Levels Of Non-invasive Serological Indicators MPV,RDW,NLR,RLR,RPR With Primary Biliary Cholangitis

ObjectivesPrimary biliary cholangitis(PBC)is a chronic autoimmune liver disease characterized by progressive destruction of the intrahepatic bile ducts,leading to cholestasis,eventually leading to the development of cirrhosis.For patients with PBC,liver biopsy is the most accurate method for diagnosis,histological staging,and prognosis.However,the usage of liver biopsy is limited due to its invasiveness.The current studies shows,Non-invasive serological indicators and parameters include mean platelet volume(MPV),red blood cell Distribution Width(RDW),neutrophil to lymphocyte ratio(NLR),red blood cell distribution width to Platelet Ratio(RLR),red cell width distribution to lymphocyte ratio(RPR)have important value in the degree of fibrosis and prognosis of chronic liver disease.Nevertheless,there are few studies on the diagnosis,histological stage,and prognosis of these serological indicators and parameters in PBC.In our study,we aimed to observe the levels and changes of MPV,RDW,NLR,RLR,and RPR and to investigate the value of their changes on histological stage,therapeutic effects of UDCA and prognosis of the patients with PBC.Method72 patients with PBC and 50 healthy individuals who visited the Second Affiliated Hospital of Kunming Medical University Digestive Diseases between 2014 and 2019 were included in our study.All the patients received UDCA treatment and had been followed up more than 1 year.Their clinical data,were collected before and after UDCA treatment in 12 months,respectively.SPSS softwere(SPSS25.0)was used for subsequent analysis and P<0.05 was considered significant.Result1.The basal levels of RDW-SD,NLR,RLR,RPR in PBC patients were significantly higher than those of healthy controls.The difference was statistically significant.Although the level of MPV in PBC patients was higher than that of healthy controls,there was no statistical difference.2.The basal levels of RDW-SD,NLR,RLR,RPR were higher in advanced stage of PBC.3.After UDCA treatment,the levels of RDW-SD,NLR,RLR,RPR in PBC patients showed remarkable decrease when compared to their basal level4.The basal levels of RDW-SD,NLR,RLR,RPR.and MPV were not statistically different between UDCA responders and non-responders.5.According to Mayo risk score,we found that the basal levels of RDW-SD,RLR,RPR in the patients with a higher score were higher than in patients with a lower score.The level of RDW-SD,RLR,RPR were positively correlated with Mayo score.6.According to GLOBE score,we found that the basal levels of RLR,RPR in the patients with a higher score were higher than in patients with a lower score.However,the level of RLR,RPR have no significant linear relationship with GLOBE score.7.According to Mayo risk score?GLOBE score and UK-PBC score,we found that the basal levels of RDW-SD,RLR,RPR in the patients with a higher score were higher than in patients with a lower score.The level of RDW-SD were positively correlated with UK-PBC score.8.NLR closely related to 1-year mortality in PBC patients with decompensated,and its predictive efficacy is higher than the MELD score.Conclusion1.The levels of RDW-SD,NLR,RLR,and RPR gradually increase with the progress of PBC,which can reflect the histological stage of PBC and are expected to become serological indicators of disease stage.2.After treatment with UDCA,the levels of RDW-SD,NLR,RLR,and RPR in PBC patients decreased,but UDCA response efficacy could not be distinguished.3.The increase in RDW-SD,RLR,and RPR indicates that the patients have a poor prognosis.4.The efficacy of NLR in evaluating the mortality rate in PBC patients wtih decompensated within 1 year is better than the MELD score.