Sène Damien, Limal Nicholas, Messous Djamila, Ghillani-Dalbin Pascale, Charlotte Frédéric, Thiollière Jean-Marie, Piette Jean-Charles, Imbert-Bismut Françoise, Halfon Philippe, Poynard Thierry, Cacoub Patrice
Department of Internal Medicine, La Pitié-Salpêtrière Hospital, France.
Clin Biochem. 2006 Jul;39(7):715-21. doi: 10.1016/j.clinbiochem.2006.04.019.
We assessed the reliability of non-invasive biological scoring indexes (Fibrotest-Actitest [FT-AT], Forns, APRI, age-platelet, platelet, hyaluronic acid) as non-invasive alternatives to liver biopsy (LB) in 138 HCV-infected patients.
Thirty-six of 138 (26%) patients had systemic vasculitis, 27% significant serum inflammation, 47% fibrosis (F2F3F4) on LB. The diagnostic value of FT (F2F3F4 vs. F0F1) was assessed by an AUC of 0.83, without difference regarding to systemic vasculitis or serum inflammation. A discordance between FT-AT and the Metavir scoring indexes, present in 29% of patients, was associated with serum hemolysis and male but not with systemic vasculitis or serum inflammation. The other non-invasive biological tests were not influenced by serum inflammation or systemic vasculitis but were less reliable than FT (P <or= 0.05).
The FT-AT is a reliable non-invasive biochemical alternative to LB in HCV-infected patients with systemic vasculitis and is more reliable than other non-invasive biological indexes.
我们评估了138例丙型肝炎病毒（HCV）感染患者中，非侵入性生物学评分指标（Fibrotest-Actitest [FT-AT]、Forns指数、APRI指数、年龄-血小板指数、血小板、透明质酸）作为肝活检（LB）非侵入性替代方法的可靠性。
138例患者中有36例（26%）患有系统性血管炎，27%有显著血清炎症，47%在肝活检时有纤维化（F2F3F4）。FT（F2F3F4与F0F1）的诊断价值通过曲线下面积（AUC）为0.83进行评估，在系统性血管炎或血清炎症方面无差异。FT-AT与Metavir评分指标之间的不一致性存在于29%的患者中，与血清溶血和男性相关，但与系统性血管炎或血清炎症无关。其他非侵入性生物学检测不受血清炎症或系统性血管炎影响，但比FT可靠性低（P≤0.05）。
在患有系统性血管炎的HCV感染患者中，FT-AT是一种可靠的肝活检非侵入性生化替代方法，且比其他非侵入性生物学指标更可靠。
