Mao Weilin, Sun Qinqin, Fan Jian, Lin Sha, Ye Bo
From the Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang (WM, JF, SL, BY) and Department of Urology, The Sixth Affiliated Hospital of Xinjiang Medical University, Xinjiang (S-QQ), China.
Medicine (Baltimore). 2016 Mar;95(9):e2946. doi: 10.1097/MD.0000000000002946.
Aspartate aminotransferase to platelet ratio index (APRI) has originally been considered as a noninvasive marker for detecting hepatic fibrosis in patients with chronic hepatitis B and C. APRI has been used for predicting liver-related mortality in patients with chronic hepatitis C virus infection or alcoholic liver disease. However, whether APRI could be useful for predicting mortality in chronic hepatitis B virus (HBV) infection remains unevaluated. This study aims to address this knowledge gap. A total of 193 hospitalized chronic HBV-infected patients (cirrhosis, n = 100; noncirrhosis, n = 93) and 88 healthy subjects were retrospectively enrolled. All patients were followed up for 4 months. Mortality that occurred within 90 days of hospital stay was compared among patients with different APRI. APRI predictive value was evaluated by univariate and multivariate regression embedded in a Cox proportional hazards model. APRI varied significantly in our cohort (range, 0.16-10.00). Elevated APRI was associated with increased severity of liver disease and 3-month mortality in hospitalized patients with HBV-related cirrhosis. Multivariate analysis demonstrated that APRI (odds ratio: 1.456, P < 0.001) and the model for end-stage liver disease score (odds ratio: 1.194, P < 0.001) were 2 independent markers for predicting mortality. APRI is a simple marker that may serve as an additional predictor of 3-month mortality in hospitalized patients with HBV-related decompensated cirrhosis.
天冬氨酸转氨酶与血小板比值指数（APRI）最初被认为是检测慢性乙型和丙型肝炎患者肝纤维化的非侵入性标志物。APRI已被用于预测慢性丙型肝炎病毒感染或酒精性肝病患者的肝脏相关死亡率。然而，APRI是否可用于预测慢性乙型肝炎病毒（HBV）感染患者的死亡率仍未得到评估。本研究旨在填补这一知识空白。共回顾性纳入了193例住院的慢性HBV感染患者（肝硬化患者100例，非肝硬化患者93例）和88例健康受试者。所有患者均随访4个月。比较不同APRI患者住院90天内的死亡率。通过Cox比例风险模型中的单变量和多变量回归评估APRI的预测价值。在我们的队列中，APRI差异显著（范围为0.16 - 10.00）。APRI升高与HBV相关肝硬化住院患者的肝病严重程度增加和3个月死亡率增加相关。多变量分析表明，APRI（比值比：1.456，P < 0.001）和终末期肝病评分模型（比值比：1.194，P < 0.001）是预测死亡率的两个独立标志物。APRI是一个简单的标志物，可作为HBV相关失代偿性肝硬化住院患者3个月死亡率的额外预测指标。
