Department of Pediatric Gastroenterology and Hepatology, B J Wadia Hospital for Children, Mumbai, India.
Ann Hepatol. 2018;17(4):592-595. doi: 10.5604/01.3001.0012.0924.
Neonatal cholestasis constitutes for 19 to 33% of all chronic liver disease in India. Cholestasis leads to fibrosis of liver and ultimately cirrhosis. There are various methods of diagnosis of fibrosis of liver like fibroscan, APRI index, FIB-4, fibro index, forns index, heap score, magnetic elastography. Here we are comparing APRI index with METAVIR index in patients with neonatal cholestasis without biliary atresia and determining whether APRI index can be used as a tool to determine fibrosis in these patients.
Patients with neonatal cholestasis without biliary atresia were included in the study. This retrospective analysis was done between 2009 and 2015. All patients underwent a liver biopsy and METAVIR index was calculated. APRI at the time of liver biopsy was determined.
Forty-eight patients were included in this study with mean age of 3.5 ± 2.8 months with a male: female ratio of 35:13. Metavir Index F0 was seen in was 32 (66.67%) patients, F1 in 6(12.5%), F2 in 4(8.33%), F3 in 0 and F4 in 6(12.5%) patients respectively. Mean APRI for F0-F3 was 1.38 and for F4 was 3.74 respectively. With an APRI of 1.38, the sensitivity and specificity to detect fibrosis/cirrhosis was 100% and 21.43% respectively.
APRI is not an effective tool to measure fibrosis or cirrhosis in patients with non-BA neonatal cholestasis in Indian children.
新生儿胆汁淤积症占印度所有慢性肝病的 19%至 33%。胆汁淤积可导致肝脏纤维化，最终导致肝硬化。有多种方法可以诊断肝纤维化，如 Fibroscan、APRI 指数、FIB-4、肝纤维化指数、Forns 指数、heap 评分、磁共振弹性成像。在这里，我们将 APRI 指数与无胆道闭锁的新生儿胆汁淤积症患者的 METAVIR 指数进行比较，并确定 APRI 指数是否可以作为确定这些患者纤维化的工具。
本研究纳入了无胆道闭锁的新生儿胆汁淤积症患者。这是一项回顾性分析，时间为 2009 年至 2015 年。所有患者均接受了肝活检，并计算了 METAVIR 指数。同时测定肝活检时的 APRI。
本研究共纳入 48 例患者，平均年龄为 3.5±2.8 个月，男女比例为 35:13。Metavir 指数 F0 患者 32 例（66.67%），F1 患者 6 例（12.5%），F2 患者 4 例（8.33%），F3 患者 0 例，F4 患者 6 例（12.5%）。F0-F3 患者的平均 APRI 为 1.38，F4 患者的平均 APRI 为 3.74。APRI 为 1.38 时，检测纤维化/肝硬化的灵敏度和特异性分别为 100%和 21.43%。
APRI 不是评估印度儿童非 BA 新生儿胆汁淤积症患者纤维化或肝硬化的有效工具。
