Ding Deping, Li Hongbing, Liu Ping, Chen Lingli, Kang Jian, Zhang Yinhua, Ma Deqiang, Chen Yue, Luo Jie, Meng Zhongji
Department of Infectious Diseases, Taihe Hospital, Hubei University of Medicine Shiyan 442000, China.
Department of Infectious Disease, Weinan Central Hospital Weinan 714000, China.
Int J Clin Exp Med. 2015 Nov 15;8(11):20876-82. eCollection 2015.
The aim of this study was to assess the effects of FibroScan, aspartate aminotransferase and alanine aminotransferase ratio (AAR), aspartate aminotransferase to platelet ratio index (APRI), fibrosis index based on the 4 factor (FIB-4) and their combinations on liver fibrosis in patients with hepatitis B.
406 hospitalized patients with chronic hepatitis B (CHB) and cirrhosis in our hospital were analyzed retrospectively and collected patients clinical indicators, including liver stiffness (LS), AAR, APRI and FIB-4, and then compared the differences of these indicators between CHB group and hepatitis B with cirrhosis group. Receiver operating curve (ROC) was used to evaluate the differentiating capacity of these indicators on CHB and liver cirrhosis.
Four indicators related to liver cirrhosis had a statistical significance between two groups (P < 0.01); the under ROC curve areas of LS, AAR, APRI and FIB-4 for differential diagnosis of CHB and liver cirrhosis were 0.866, 0.772, 0.632 and 0.885, respectively. The under ROC curve areas of LS, AAR, APRI and FIB-4 for differential diagnosis of liver cirrhosis at compensatory stage and de-compensatory stage were 0.627, 0.666, 0.795 and 0.820, respectively.
LS, AAR, APRI and FIB-4 were good indicators as clinical diagnosis and differential diagnosis on hepatitis B related cirrhosis.
本研究旨在评估FibroScan、天冬氨酸氨基转移酶与丙氨酸氨基转移酶比值(AAR)、天冬氨酸氨基转移酶与血小板比值指数(APRI)、基于4项因子的纤维化指数(FIB-4)及其组合对乙型肝炎患者肝纤维化的影响。
回顾性分析我院406例住院慢性乙型肝炎(CHB)和肝硬化患者,收集患者的临床指标,包括肝脏硬度(LS)、AAR、APRI和FIB-4,然后比较CHB组和乙型肝炎肝硬化组这些指标的差异。采用受试者工作特征曲线(ROC)评估这些指标对CHB和肝硬化的鉴别能力。
与肝硬化相关的4项指标在两组间有统计学意义(P<0.01);LS、AAR、APRI和FIB-4鉴别诊断CHB和肝硬化的ROC曲线下面积分别为0.866、0.772、0.632和0.885。LS、AAR、APRI和FIB-4鉴别诊断代偿期和失代偿期肝硬化的ROC曲线下面积分别为0.627、0.666、0.795和0.820。
LS、AAR、APRI和FIB-4是乙型肝炎相关肝硬化临床诊断和鉴别诊断的良好指标。