Objective To analyze the relationship between mean platelet volume ( MPV) in patients with hepatitis B and hepatitis activity level, and to explore the value of MPV in diagnosis of activity of hepatitis B.Methods From March 2012 to March 2014, 68 cases of chronic hepatitis B patients were enrolled as the observation group, according to the extent of the disease, they were divided into mild subgroup of 38 cases, moderate subgroup of 23 cases, severe subgroup of 7 cases, healthy subjects of 60 cases were enrolled as health control group.Analyzed and evaluated the value of MPV in diagnosis of hepatitis activity in patients with hepatitis B.Results Alanine aminotransferase ( ALT) , aspartate aminotransferase ( AST) , serum bilirubin( TB) , immunoglobulin and MPV levels in patients with hepatitis B were higher than that in healthy control group ( t =-7.4, t =-6.9, t =-9.7, t =-8.3, t =-2.2, P <0.01 or P <0.05), in hepatitis B patients, AST, TB, immunoglobulin, MPV in the mild hepatitis patients were lower than in the moderate hepatitis patients ( t =9.6, t =7.0, t =7.3, t =3.1, P <0.01), and serum ALT, MPV in patients with moderate hepatitis were lower than that of severe hepatitis patients ( t =8.7, t =2.4, P <0.05).Draw the receiver operating characteristic curve, for the diagnosis of severe hepatitis patients, MPV in the area under the curve was 0.773(95%CI 0.663-0.883, P <0.01), when the threshold value for diagnosis of MPV was 10.9 fl, the diagnostic sensitivity was 68.0%, specificity was 86.0%, the positive predictive value was 79.2%, the negative predictive value was 77.4%, OR=13.1.Conclusion Serum MPV value increases with hepatitis activity level, sensitivity and specificity in diagnosis of severe hepatitis is good.%目的：分析乙型肝炎患者平均血小板容积（ MPV）与肝炎活动程度的关系，探讨MPV对乙型肝炎患者肝炎活动度的提示和诊断价值。方法选取2012年3月—2014年3月被确诊为慢性乙型肝炎的患者68例为观察组，根据疾病程度分为轻度亚组38例、中度亚组23例、重度亚组7例，并选择同期健康体检者60例为健康对照组。分析并评价MPV对乙型肝炎患者肝炎活动程度的诊断价值。结果观察组患者的谷氨酸氨基移酶（ ALT）、天冬氨酸氨基转移酶（AST）、血胆红素（TB）、球蛋白（Glo）和MPV的水平均高于健康对照组（ t ＝－7刎．4、－6．9、－9．7、－8．3、－2．2， P ＜0．01或0．05），在乙型肝炎患者中，轻度肝炎的患者血清中AST、TB、Glo、MPV均低于中度肝炎的患者（t ＝9．6、7．0、7．3、3．1， P ＜0．01），而中度肝炎患者血清中ALT、MPV低于重度肝炎的患者（ t ＝8．7、2．4， P ＜0．05）。绘制受试者工作曲线，MPV对中重度肝炎患者的诊断曲线下面积为0．773（95％CI 0．663～0．883， P ＜0．01），当MPV的诊断阈值为10．9 fl时，诊断的灵敏度为68．0％，特异度为86．0％，阳性预测值为79．2％，阴性预测值为77．4％，OR值＝13．1。结论血清MPV水平随着肝炎活动程度的加重而增大，对中重度肝炎诊断的灵敏度和特异性均较佳，具有良好的提示作用。
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