4th Medical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Medical Informatics and Biostatistics, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Eur J Clin Invest. 2015 Dec;45(12):1243-51. doi: 10.1111/eci.12543. Epub 2015 Nov 2.
Hyaluronic acid (HA), ASAT to Platelet Ratio Index (APRI), ASAT/ALAT ratio, Fibrosis 4 score (FIB4) and FibroScan were studied as non-invasive markers of liver fibrosis (F) in chronic viral hepatitis B (CHB) and C (CHC), in an attempt to avoid the complications of liver puncture biopsy, considered the gold standard in the evaluation of F. The aim of our research was to study whether HA, APRI, ASAT/ALAT ratio, FIB4 and FibroScan are useful non-invasive markers in predicting severe F in Romanian patients.
This was a prospective multicenter transversal and observational study, which included 76 patients with CHB/CHC. The independent effect of studied markers was tested using multiple binary logistic regression.
In patients with CHB and CHC, the APRI cut-off value for F4 was 0·70 ng/mL (Se = 77%, Sp = 78%), the FIB4 cut-off value was 2·01 (Se = 77%, Sp = 69%), and the FibroScan cut-off value was 13·15 (Se = 92%, Sp = 88%). For patients with CHB/CHC, there was a significant linear positive correlation between F and HA (r = 0·42, P = 0·001), FibroScan (r = 0·67, P < 0·001), APRI (r = 0·46, P < 0·001) and FIB4 (r = 0·51, P < 0·001). Considering age, sex and body mass index as possible confounding factors or covariates in multivariable logistic modelling, FibroScan was the unique test that able to significantly highlight the presence of F4 score in CHB/CHC patients (P = 0·009) while FIB4 test seems to have a tendency to statistical significance.
FibroScan, APRI and FIB4 are useful non-invasive tests for the evaluation of F4 in patients with CHB and CHC.
透明质酸（HA）、血小板比率指数（APRI）、天门冬氨酸氨基转移酶/丙氨酸氨基转移酶比值（ASAT/ALAT 比值）、纤维化 4 评分（FIB4）和 FibroScan 已被研究作为慢性乙型肝炎（CHB）和丙型肝炎（CHC）患者肝纤维化（F）的非侵入性标志物，以试图避免肝穿刺活检的并发症，肝穿刺活检被认为是 F 评估的金标准。我们的研究目的是研究透明质酸、APRI、ASAT/ALAT 比值、FIB4 和 FibroScan 是否可作为预测罗马尼亚患者严重 F 的有用非侵入性标志物。
这是一项前瞻性多中心横断面观察性研究，纳入了 76 例 CHB/CHC 患者。使用多元二项逻辑回归测试研究标志物的独立影响。
在 CHB 和 CHC 患者中，F4 的 APRI 截断值为 0·70ng/mL（Se = 77%，Sp = 78%），FIB4 的截断值为 2·01（Se = 77%，Sp = 69%），FibroScan 的截断值为 13·15（Se = 92%，Sp = 88%）。对于 CHB/CHC 患者，F 与透明质酸（r = 0·42，P = 0·001）、FibroScan（r = 0·67，P<0·001）、APRI（r = 0·46，P<0·001）和 FIB4（r = 0·51，P<0·001）之间存在显著的线性正相关。在多变量逻辑模型中考虑年龄、性别和体重指数作为可能的混杂因素或协变量时，FibroScan 是唯一能够显著提示 CHB/CHC 患者存在 F4 评分的检测方法（P = 0·009），而 FIB4 检测似乎具有统计学意义的趋势。
FibroScan、APRI 和 FIB4 是评估 CHB 和 CHC 患者 F4 的有用非侵入性检测方法。
