Zhang Zhi-Qiao, Wang Gong-Sui, Kang Kai-Fu, Wu Guo-Biao, Wang Peng
Department of Infectious Diseases, The Shunde First People's Hospital, Shunde, Guangdong, China.
Department of Pathology, The Shunde First People's Hospital, Shunde, Guangdong, China.
Dig Liver Dis. 2016 Aug;48(8):914-20. doi: 10.1016/j.dld.2016.05.003. Epub 2016 May 10.
To establish a simple economical diagnostic tool for prediction of hepatic steatosis in patients with hepatitis B virus (HBV) infection.
From January 2006 to January 2015,a total of 1325 consecutive subjects who underwent liver biopsy were enrolled. According to the results of multivariate logistic regression analysis, a new nomogram was conducted. Then discrimination and calibration were conducted to assess the clinical diagnostic value of nomogram.
The nomogram consisted of age, triglyceride (TG), low-density lipoprotein (LDL), uric acid (UA), haemoglobin (HGB). For prediction of hepatic steatosis, the AUROC of nomogram was 0.792 (95%CI: 0.758-0.826). With cut off value of 0.11, 699 (52.8%) of 1325 patients could be free from liver biopsy with a correct rate of 95.3% for diagnosis of hepatic steatosis.
The nomogram for hepatic steatosis has a better clinical diagnostic value for prediction of hepatic steatosis in patients with HBV infection. From the perspective of cost-effectiveness and clinical practice, it is worth considering the use of the nomogram as a mass screening tool before further liver biopsy or imaging examinations.
建立一种简单经济的诊断工具,用于预测乙型肝炎病毒(HBV)感染患者的肝脂肪变性。
纳入2006年1月至2015年1月期间连续接受肝活检的1325名受试者。根据多因素逻辑回归分析结果,构建了一个新的列线图。然后进行判别和校准,以评估列线图的临床诊断价值。
列线图由年龄、甘油三酯(TG)、低密度脂蛋白(LDL)、尿酸(UA)、血红蛋白(HGB)组成。用于预测肝脂肪变性时,列线图的曲线下面积(AUROC)为0.792(95%可信区间:0.758 - 0.826)。截断值为0.11时,1325例患者中有699例(52.8%)无需进行肝活检,诊断肝脂肪变性的正确率为95.3%。
肝脂肪变性列线图对预测HBV感染患者的肝脂肪变性具有较好的临床诊断价值。从成本效益和临床实践的角度来看,在进一步进行肝活检或影像学检查之前,值得考虑将列线图用作大规模筛查工具。