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丙型肝炎病毒感染患者中慢性肝炎与肝硬化的鉴别。利用常见实验室数据的实用判别函数。

Distinction between chronic hepatitis and liver cirrhosis in patients with hepatitis C virus infection. Practical discriminant function using common laboratory data.

作者信息

Ikeda K, Saitoh S, Kobayashi M, Suzuki Y, Tsubota A, Suzuki F, Arase Y, Murashima N, Chayama K, Kumada H

机构信息

Department of Gastroenterology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, 105 8470, Tokyo, Japan

出版信息

Hepatol Res. 2000 Nov;18(3):252-266. doi: 10.1016/s1386-6346(00)00074-7.

DOI:10.1016/s1386-6346(00)00074-7
PMID:11058829
Abstract

In order to distinguish patients with cirrhosis from those with chronic hepatitis, multivariate discriminant analysis was performed using common laboratory data. A total of 205 consecutive patients were diagnosed by peritoneoscopy and biopsy as having chronic liver disease caused by hepatitis C virus (HCV), 168 with chronic hepatitis and 37 with cirrhosis. Twenty variables and their natural logarithmic transformation were employed in the multivariate analysis. After stepwise variable selection, the following function was finally obtained to discriminate the disease severity, z=0.120xgamma-globulin (%)+0.423xln (hyaluronate) (µg l(-1))-0.059xplatelet (x10(4) counts per mm(3))-0.364xsex (male, 1; female, 2)-3.953. Since the function contained an expression of logarithm and was slightly troublesome to apply, we prepared another discriminant function composed of usual figures without logarithmic transformation, z=0.124x(gamma-globulin (%))+0.001x(hyaluronate) (µg l(-1))-0.075x(platelet (x10(4) counts per mm(3)))-0.413xgender (male, 1; female, 2)-2.005. When a positive result is calculated in the latter equation, the diagnosis of the liver disease indicates cirrhosis, and negative result chronic hepatitis. Accuracy of the two discriminant functions was 90.3 and 91.2%, respectively. A concise linear discriminant function could successfully differentiate liver cirrhosis from chronic hepatitis with an accuracy of 91.2%.

摘要

为了区分肝硬化患者和慢性肝炎患者,利用常见实验室数据进行了多变量判别分析。共有205例连续患者经腹腔镜检查和活检诊断为丙型肝炎病毒(HCV)引起的慢性肝病,其中168例为慢性肝炎,37例为肝硬化。多变量分析采用了20个变量及其自然对数变换。经过逐步变量选择,最终得到以下判别疾病严重程度的函数:z = 0.120×γ-球蛋白(%)+ 0.423×ln(透明质酸)(μg l⁻¹) - 0.059×血小板(×10⁴个/mm³) - 0.364×性别(男性为1;女性为2) - 3.953。由于该函数包含对数表达式,应用起来稍显麻烦,我们又准备了另一个由无对数变换的常规数字组成的判别函数:z = 0.124×(γ-球蛋白(%))+ 0.001×(透明质酸)(μg l⁻¹) - 0.075×(血小板(×10⁴个/mm³)) - 0.413×性别(男性为1;女性为2) - 2.005。当在后一个方程中计算出阳性结果时,肝病诊断为肝硬化,阴性结果为慢性肝炎。这两个判别函数的准确率分别为90.3%和91.2%。一个简洁的线性判别函数能够成功区分肝硬化和慢性肝炎,准确率为91.2%。

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