The Clinical Value Of Red Blood Cell Distribution Width To Platelet Ratio In Patients With Hepatitis B Virus-related Cirrhosis On Diagnosis And Prognosis Assessment

Objective Eploring the value of red blood cell to platelet ratio(RPR)in patients with hepatitis B virus-related cirrhosis.Methods A total of 144 patients who were diagnosed with hepatitis B virus-ralated cirrhosis,80 cases with chronic hepatitis B and 80 cases of healthy check-up were enrolled at our hospital affiliated to Anhui Medical University between January 2013 and December 2015.Red blood cell distribution width(RDW),platelet(PLT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and other clinical indicators from inpatient and outpatient information were tested,at the same time,red blood cell distribution width to platelet ratio(RPR),aspartate amino transferase to platelet ratio index(APRI),fibrosis index based on the four factors(FIB-4)and Chid-Pugh score were calculated.Data were analyzed using spearman correlation analysis,draw receiver operating characteristic(ROC)curve and calculat area under the curve(AUC),value of RPR in predicting hepatic cirrhosis was also tested.Patients with Hepatitis B virus-ralated cirrhosis were divided into two groups,data analyses were done by Kaplan-Meier survival analysis,in the same time,receiver operating characteristic(ROC)curve of RPR value for 54 death patients was drawm.Results RPR both of patients with chronic hepatitis B and with hepatitis B virus-ralated cirrhosis group,were signifcantly higher than healthy examination group;the RPR of Hepatitis B virus-ralated cirrhosis group is significantly higher than that of chronic hepatitis B group,(P<0.01).RPR,FIB-4,APRI were all positively correlated with hepatitis B virus-ralated cirrhosis(P<0.01).The AUC of RPR for prediction of cirrhosis is 0.91,inferior to the RPR of FIB-4(0.94,P<0.05),better than that of APRI(0.85,P<0.05).The cut-off value of RPR is0.43(sensitivity:84%,specificity : 90%),3.00 was that of FIB-4(sensitivity : 82%,specificity :95%),which of APRI is 0.43(sensitivity:84%,specificity:76%).Child-Pugh score(CP score)was correlated to RPR,r=0.35,P < 0.01,and the model for end-stage liver disease(MELD)was also correlated to RPR,r=0.34,P< 0.01.The 3-year survival rate of high RPR group and low RPR group were 56.80% and 68.60%,respectively.RPR was not a risk factor to predict the death of patients with HBV-related cirrhosis.RPR combined with CP score could improve the sensitivity and specificity of CP score for prognostic evaluation in patients with HBV-related cirrhosis.Conclusion RPR may proved to be a useful index to estimate HBV-related cirrhosis diagnosis.When combined with RPR,the performance of CP score could be improved in prognosis assessment of patients with hepatitis B virus-related cirrhosis.