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肝脂肪变性列线图:一种用于大规模筛查的简单且经济的诊断工具。

Nomogram for hepatic steatosis: A simple and economical diagnostic tool for massive screening.

作者信息

Zhang Zhi-Qiao, Wang Gong-Sui, Kang Kai-Fu, Wu Guo-Biao, Wang Peng

机构信息

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.

出版信息

Dig Liver Dis. 2016 Aug;48(8):914-20. doi: 10.1016/j.dld.2016.05.003. Epub 2016 May 10.

Abstract

AIM

To establish a simple economical diagnostic tool for prediction of hepatic steatosis in patients with hepatitis B virus (HBV) infection.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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%。

结论

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。

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