CORRELATIONS BETWEEN CLINICAL, HEMATOLOGICAL, BIOCHEMICAL AND INTEGRATIVE INDICATORS AND THE DEGREE OF FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS C
Abstract
Background. Chronic hepatitis C is a liver disease that often leads to liver cirrhosis and hepatocellular carcinoma. Objective – to establish correlations between clinical, laboratory, integrative parameters and non-invasive methods for calculating liver fibrosis in patients with chronic hepatitis C. Material and methods. In 287 patients with chronic hepatitis C, who were divided into 5 groups (according to the degree of fibrosis (F)); clinical features, laboratory parameters were studied; integrative indicators, APRI (AST to Platelet Ratio Index) and FIB-4 (Fibrosis-4 Index for Liver) were calculated. Statistical analysis was carried out using the programs Microsoft Office Excel 2016, IBM SPSS Statistics with the calculation of nonparametric criteria. Results. Male patients with moderately severe fibrosis, 1b genotype and minimal activity predominated. A direct correlation was established between F (METAVIR) and FIB-4 (p <0.05), FIB-4 and APRI (p <0.05) and a tendency to correlation between F (METAVIR) and APRI. There was a direct relationship between F (METAVIR), APRI, FIB-4 and age, and body mass index (p <0.05). An inverse correlation was established between F (METAVIR), APRI, FIB-4 and platelet count; F (METAVIR) and the activity of ALT, AST, GGTP; between APRI, FIB-4 and white blood cell count, FIB-4 and red blood cell count (p <0.05). Direct connections were observed between these three indicators of fibrosis and bilirubin; F (METAVIR) and alkaline phosphatase; APRI, FIB-4 and ESR, the activity of ALT, AST and GGTP; FIB-4 and the De Ritis ratio (p <0.05). Conclusions. An increase in the degree of fibrosis is inversely correlated with the count of platelets, leukocytes and red blood cells, and is in direct proportion to ESR and bilirubin. The correlation of integrative indicators with an increase in the degree of fibrosis indicated increased intoxication associated with autoimmune process, a decrease in non-specific immunoreactivity.References
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