目的: 分析乙型肝炎病毒(HBV)感染原发性肝癌患者的血常规指标与肝功能、HBV病毒载量以及预后不良的关系。方法: 选取2018年6月至2021年1月收治的肝癌患者124例,纳入肝癌组,并收集同期治疗及体检的肝硬化患者、健康者各100例,分别纳入肝硬化组、对照组,比较3组患者血常规指标[红细胞计数(RBC)、红细胞比容(HCT)、血红蛋白(Hb)含量、平均红细胞体积(MCV)、中性粒细胞与淋巴细胞比值(NLR)],并根据不同肝功分级、病毒载量、预后情况分组观察肝癌患者的血常规指标表达情况,分析肝癌患者预后不良的危险因素。结果: RBC、Hb、HCT从高至低依次为对照组、肝硬化组、肝癌组(P＜0.05),MCV、NLR从高至低依次为肝癌组、肝硬化组、对照组(P＜0.05);不同肝功分级肝癌患者的RBC、Hb、HCT从高至低依次为A级、B级、C级(P＜0.05),MCV及NLR从高至低依次为C级、B级、A级(P＜0.05);不同HBV病毒载量肝癌患者的RBC、Hb、HCT从高至低依次为低拷贝组、中拷贝组、高拷贝组(P＜0.05),MCV及NLR从高至低依次为高拷贝组、中拷贝组、低拷贝组(P＜0.05);预后良好组患者RBC、Hb、HCT高于预后不良组(P＜0.05),MCV、NLR低于预后不良组(P＜0.05);HBV病毒载量、MCV、NLR、RBC、Hb、HCT及肝功能分级均为HBV感染原发性肝癌患者预后不良的危险因素(P＜0.05)。结论: HBV原发性肝癌患者的血常规指标与肝硬化患者、健康人有显著差别,且血常规指标与患者肝功能、HBV病毒载量及预后情况密切关联,应重视此类患者的血常规指标检测。

Objective: To analyze the relationship between blood routine indexes and liver function, HBV viral load and poor prognosis in patients with hepatitis B virus (HBV)-infected primary liver cancer. Methods: A total of 124 patients with liver cancer admitted from June 2018 to January 2021 were included in the liver cancer group, and 100 patients with liver cirrhosis and 100 healthy patients who received treatment and physical examination during the same period were included in the liver cirrhosis group and control group, respectively. The blood routine indexes (red blood cell count (RBC), red blood cell volume (HCT), hemoglobin (Hb) content, mean red blood cell volume (MCV), neutrophil-lymphocyte ratio (NLR)) of the three groups were compared, and the expression of blood routine indexes of liver cancer patients was observed in different groups according to different liver function grades, viral load and prognosis. The risk factors of poor prognosis in patients with liver cancer were analyzed. Results: RBC, Hb, HCT from high to low were the control group, the liver cirrhosis group, and the liver cancer group (P＜0.05), and MCV and NLR from high to low were the liver cancer group, the liver cirrhosis group, and the control group (P＜0.05). The RBC, Hb and HCT of liver cancer patients with different liver function grades were grade A, grade B and grade C from high to low (P＜0.05), and the MCV and NLR were grade C, grade B and grade A from high to low (P＜0.05). In liver cancer patients with different HBV viral load, RBC, Hb and HCT from high to low were successively low copy group, medium copy group and high copy group (P＜0.05), and MCV and NLR from high to low were successively high copy group, medium copy group and low copy group (P＜0.05). The RBC, Hb and HCT of good prognosis group were higher than those of poor prognosis group (P＜0.05), while the MCV and NLR of good prognosis group were lower than those of poor prognosis group (P＜0.05). HBV viral load, MCV, NLR, RBC, Hb, HCT and liver function grading were all risk factors for poor prognosis in patients with primary liver cancer infected with HBV (P＜0.05). Conclusion: The blood routine indexes of patients with HBV primary liver cancer are significantly different from those of patients with cirrhosis and healthy people, and the blood routine indexes are closely related to the liver function, HBV viral load and prognosis of patients, so attention should be paid to the detection of blood routine indexes in these patients.