School of Public Health, China Medical University, Shenyang, China.
Clin Chim Acta. 2011 Jan 14;412(1-2):33-7. doi: 10.1016/j.cca.2010.08.032. Epub 2010 Sep 7.
Patient age as a predictive variable plays an important role in some indices and models. It was hypothesized that patient age might be a categorical marker.
We collected the data of 623 CHB patients with liver biopsies. Two-hundred fifty-two patients could provide the duration of HBsAg-positive.
The positive correlation between duration of HBsAg-positive and patient age was statistically significant (r = 0.487, P < 0.001). When the cutoff value of patient age was 33.5 y, the best accuracy for liver fibrosis could be obtained. If we could use APRI threshold value of 0.11 for patients with age ≤ 35 and 0.18 for those > 35 y, we could correctly identify 110 CHB patients with insignificant fibrosis which were free of liver biopsy. For all CHB patients based on the APRI threshold of 0.11, 75 patients could be safely predicted as insignificant fibrosis.
Many more CHB patients with insignificant fibrosis could be free of liver biopsy when we used different APRI threshold values based on patient age, especially in patients with > 35 y. The study indicated that more attention should be paid to the influence of patient age on fibrosis.
患者年龄作为预测变量在某些指标和模型中起着重要作用。有人假设患者年龄可能是一个分类标志物。
我们收集了 623 例有肝活检的 CHB 患者的数据。其中 252 例患者可以提供 HBsAg 阳性的持续时间。
HBsAg 阳性持续时间与患者年龄之间存在显著的正相关（r = 0.487，P < 0.001）。当患者年龄的截止值为 33.5 岁时，肝纤维化的最佳准确性可以获得。如果我们能够为年龄≤35 岁的患者使用 APRI 截断值为 0.11，为年龄>35 岁的患者使用 APRI 截断值为 0.18，我们可以正确识别 110 例无肝活检的无显著纤维化的 CHB 患者。对于所有基于 APRI 截断值为 0.11 的 CHB 患者，75 例患者可以安全地预测为无显著纤维化。
当我们根据患者年龄使用不同的 APRI 截断值时，可以有更多的 CHB 无显著纤维化患者免于肝活检，尤其是年龄>35 岁的患者。该研究表明，应更加注意患者年龄对纤维化的影响。
