Department of Infectious Diseases and Hepatology, Huashan Hospital, Fudan University, Shanghai 200040, China.
Sci Rep. 2016 Sep 12;6:33093. doi: 10.1038/srep33093.
We determined the association between various clinical parameters and significant liver necroinflammation in patients with chronic hepatitis B (CHB) related cirrhosis. Two hundred patients with CHB related cirrhosis were recruited in the final analysis. Clinical laboratory values and characteristics were obtained from the medical record. We performed analyses of the relationships between independent variables and significant liver necroinflammation by using binary logistic regression analysis and discriminant analysis. Significant liver necroinflammation (grade≥2) was found in 58.0% (80/138) of antiviral therapy patients and 48.4% (30/62) of non antiviral therapy patients respectively. Also, there were some significant differences in serum hepatitis B surface antigen (HBsAg), serum hepatitis B e antigen (HBeAg) and serum hepatitis B virus (HBV) DNA between antiviral therapy and non antiviral therapy patients. After that, aspartate aminotransferase (AST), total bilirubin (TBIL), total bile acid (TBA), prothrombin time (PT), aspartate aminotransferase to platelet ratio index (APRI) and serum HBV DNA were confirmed as independent predictors of significant liver necroinflammation in CHB patients with cirrhosis by univariate analysis and multivariate analysis (p = 0.002, 0.044, 0.001, 0.014, 0.01 and 0.02 respectively). Finally, receiver operating characteristic (ROC) curve analysis and discriminant analysis validated that these six variables together have strong predictive power to evaluate significant liver necroinflammation.
我们确定了各种临床参数与慢性乙型肝炎（CHB）相关肝硬化患者显著肝脏坏死性炎症之间的关联。最终分析共纳入 200 例 CHB 相关肝硬化患者。从病历中获取临床实验室值和特征。我们通过二项逻辑回归分析和判别分析来分析自变量与显著肝脏坏死性炎症之间的关系。在抗病毒治疗患者中，58.0%（80/138）存在显著肝脏坏死性炎症（≥2 级），而非抗病毒治疗患者中这一比例为 48.4%（30/62）。此外，抗病毒治疗患者和非抗病毒治疗患者的血清乙型肝炎表面抗原（HBsAg）、血清乙型肝炎 e 抗原（HBeAg）和血清乙型肝炎病毒（HBV）DNA 存在显著差异。然后，天门冬氨酸氨基转移酶（AST）、总胆红素（TBIL）、总胆汁酸（TBA）、凝血酶原时间（PT）、天门冬氨酸氨基转移酶与血小板比值指数（APRI）和血清 HBV DNA 通过单因素和多因素分析被证实为肝硬化 CHB 患者显著肝脏坏死性炎症的独立预测因子（p=0.002，0.044，0.001，0.014，0.01 和 0.02）。最后，受试者工作特征（ROC）曲线分析和判别分析验证了这六个变量联合具有评估显著肝脏坏死性炎症的强大预测能力。
