Aktug Demir Nazlim, Kolgelier Servet, Ozcimen Serap, Gungor Gokhan, Sumer Sua, Saltuk Demir Lutfi, Inkaya Ahmet Cagkan, Ural Onur
Infectious Diseases and Clinical Microbiology Department, Selcuk University, Konya, Turkey.
Infectious Diseases and Clinical Microbiology Department, Adiyaman University, Adiyaman, Turkey.
Hepat Mon. 2014 Apr 1;14(4):e16975. doi: 10.5812/hepatmon.16975. eCollection 2014 Apr.
The hepatitis B virus is an important healthcare problem. According to current clinical practice, a liver biopsy is required for the diagnosis and treatment of chronic liver disease. However, a liver biopsy is an invasive, inconvenient procedure, which requires an expert pathologist opinion. Therefore requirement of biochemical tests, which are considered to indicate hepatic fibrosis and may be repeated easily, increases gradually today.
This study evaluated the correlation between hepatic fibrosis and routine laboratory values in patients with chronic hepatitis B.
The files of 456 patients with CHB (chronic hepatitis B) who were referred to the infectious diseases and clinical microbiology clinic between January 2009 and March 2012 were screened retrospectively. Liver biopsy samples were examined according to Ishak scoring. Laboratory parameters and histopathology reports were recorded, and correlations between the fibrosis grade and laboratory parameters were analyzed.
There were 320 male and 136 female patients, with a mean age 36.7 ± 12.1 years. According to liver biopsy results, a low fibrosis score (stage 0-2) was detected in 281 patients (61.6%), and a high fibrosis score (stage 3-5) was detected in 175 patients (38.4%). Patients with a high fibrosis score had significantly higher ALT (alanine amino transferase), AST (aspartate aminotransferase), and HBV-DNA values and a significantly lower platelet count compared with those with a low fibrosis score (P = 0.001, 0.001, 0.025, and 0.001, respectively). A positive correlation was detected between the fibrosis score and age, BMI, HAI, ALT, and AST values, and a negative correlation was detected between the fibrosis score and albumin and platelet counts. In the regression analysis performed to evaluate the factors associated with high-stage fibrosis, fibrosis was determined to be associated with thrombosis, ALT, and gender. The results of the regression analysis demonstrated that the risk of fibrosis was 4.6 fold higher in men.
According to the results obtained in our study, advanced age, higher BMI, AST, ALT, and HBV-DNA levels, and low albumin and platelet levels are correlated with advanced fibrosis in patients with CHB.
乙肝病毒是一个重要的医疗问题。根据当前临床实践,慢性肝病的诊断和治疗需要进行肝活检。然而,肝活检是一种侵入性、不方便的检查,需要专家病理学家的意见。因此,如今被认为可指示肝纤维化且易于重复进行的生化检查的需求逐渐增加。
本研究评估慢性乙型肝炎患者肝纤维化与常规实验室检查值之间的相关性。
回顾性筛查了2009年1月至2012年3月间转诊至传染病和临床微生物学诊所的456例慢性乙型肝炎(CHB)患者的病历。根据Ishak评分对肝活检样本进行检查。记录实验室参数和组织病理学报告,并分析纤维化分级与实验室参数之间的相关性。
有320例男性和136例女性患者,平均年龄36.7±12.1岁。根据肝活检结果,281例患者(61.6%)检测到低纤维化评分(0 - 2期),175例患者(38.4%)检测到高纤维化评分(3 - 5期)。与低纤维化评分患者相比,高纤维化评分患者的丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和乙肝病毒DNA(HBV - DNA)值显著更高,血小板计数显著更低(P分别为0.001、0.001、0.025和0.001)。在纤维化评分与年龄、体重指数(BMI)、肝活动指数(HAI)、ALT和AST值之间检测到正相关,在纤维化评分与白蛋白和血小板计数之间检测到负相关。在评估与高分期纤维化相关因素的回归分析中,确定纤维化与血栓形成、ALT和性别有关。回归分析结果表明男性发生纤维化的风险高4.6倍。
根据我们研究获得的结果,高龄、较高的BMI、AST、ALT和HBV - DNA水平以及低白蛋白和血小板水平与慢性乙型肝炎患者的晚期纤维化相关。