Zhong Li-Kun, Zhang Guo, Luo Shuang-Yan, Yin Wu, Song Huai-Yu
Department of Gastroenterology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Department of Pathology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
J Clin Lab Anal. 2020 Jul;34(7):e23270. doi: 10.1002/jcla.23270. Epub 2020 May 4.
To investigate the value of platelet count in evaluating the degree of liver fibrosis in patients with chronic hepatitis B (CHB).
A total of 158 CHB patients who underwent liver biopsy in our hospital were included, and the clinical characteristics of these patients were retrospectively analyzed. The diagnostic values of platelet count, aspartate aminotransferase-to-platelet ratio index (APRI), and the fibrosis index based on four factors (FIB-4) for significant fibrosis (F ≥ 2) and early cirrhosis (F = 4) stages in CHB patients were assessed by the use of receiver operating characteristic (ROC) analysis.
The median (F0: 221.0; F1: 210.0; F2: 188.0; F3: 171.0; and F4: 155.5) and mean rank (F0: 120.4; F1: 100.1; F2: 82.2; F3: 67.9; and F4: 49.5) of platelet count decreased along the aggravation of fibrosis (F0-F4). The areas under the ROC curve for the platelet count in diagnosis of significant fibrosis stage was 0.70, which had no significant difference with FIB-4 (0.73) and APRI (0.68) in diagnostic efficacy (P = .428). The areas under the ROC curve of platelet count in diagnosis of early cirrhosis were 0.72, which had no significant difference with FIB-4 (0.76) and APRI (0.68) (P = .094).
The platelet count, as a simple and non-invasive index, could evaluate the degree of liver fibrosis in CHB individuals. At the same time, the diagnostic efficiency of platelet count to evaluate the significant liver fibrosis and early cirrhosis is comparable to FIB-4 and APRI.
探讨血小板计数在评估慢性乙型肝炎(CHB)患者肝纤维化程度中的价值。
纳入我院158例接受肝活检的CHB患者,回顾性分析其临床特征。采用受试者工作特征(ROC)分析评估血小板计数、天冬氨酸转氨酶与血小板比值指数(APRI)以及基于四项因子的纤维化指数(FIB-4)对CHB患者显著纤维化(F≥2)和早期肝硬化(F = 4)阶段的诊断价值。
随着纤维化程度加重(F0 - F4),血小板计数的中位数(F0:221.0;F1:210.0;F2:188.0;F3:171.0;F4:155.5)和平均秩次(F0:120.4;F1:100.1;F2:82.2;F3:67.9;F4:49.5)降低。血小板计数诊断显著纤维化阶段的ROC曲线下面积为0.70,在诊断效能上与FIB-4(0.73)和APRI(0.68)无显著差异(P = 0.428)。血小板计数诊断早期肝硬化的ROC曲线下面积为0.72,与FIB-4(0.76)和APRI(0.68)无显著差异(P = 0.094)。
血小板计数作为一种简单且无创的指标,可评估CHB患者的肝纤维化程度。同时,血小板计数评估显著肝纤维化和早期肝硬化的诊断效能与FIB-4和APRI相当。