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年龄、胆红素和白蛋白(ABA)指数:一种预测慢性丙型肝炎感染患者肝纤维化的新型无创指数。

The age, bilirubin and albumin (ABA) index: a novel noninvasive index for predicting liver fibrosis in patients with chronic hepatitis C infection.

机构信息

Department of Gastroenterology, Biruni University School of Medicine, İstanbul.

Department of Gastroenterology, Hitit University School of Medicine, Corum.

出版信息

Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e290-e296. doi: 10.1097/MEG.0000000000002038.

Abstract

AIM

It was to assess the diagnostic performance characteristics of a novel index, (ABA), which utilizes age, bilirubin and albumin to predict significant and severe fibrosis, and cirrhosis in patients with chronic hepatitis C infection.

METHODS

A total of 114 patients were included in this study. The liver biopsies were graded using the Ishak scoring system. Diagnostic performance of the ABA index was compared to aspartate aminotransferase (AST) to alanine aminotransferase ratio, age platelet index, AST to platelet ratio index, γ-glutamyl transpeptidase (GGT) to platelet ratio index, FIB-4, FibroQ, Goteborg University Cirrhosis Index, King's score, GGT/international normalization ratio, platelet to lymphocyte ratio, neutrophil to lymphocyte ratio, white blood cell to platelet distribution width ratio and mean platelet volume to platelet distribution width ratio (MPV/PDW) by receiver operating characteristics (ROC) curve analysis.

RESULTS

The ABA index was formulated as 1.5 + (0.065 × age) + (1.85 × bilirubin) - (1.65 × albumin) according to the multivariate logistic regression analysis. According to the ROC curve analyses, the ABA index had the area under these ROC curves (AUROCs) of 0.805 [95% confidence interval (CI), 0.727-0.883] for significant fibrosis, 0.874 (95% CI, 0.804-0.943) for severe fibrosis and 0.895 (95% CI, 0.828-0.961) for cirrhosis.

CONCLUSION

The ABA index was found to be superior to other evaluated noninvasive indexes of liver fibrosis by use of the cutoff point of 0 and 1. These findings should be confirmed by prospective and multicenter studies in patients with chronic hepatitis C infection.

摘要

目的

评估一种新指数(ABA)的诊断性能特征,该指数利用年龄、胆红素和白蛋白预测慢性丙型肝炎感染患者的显著和严重纤维化及肝硬化。

方法

本研究共纳入 114 例患者。采用 Ishak 评分系统对肝组织进行分级。将 ABA 指数的诊断性能与天门冬氨酸氨基转移酶(AST)/丙氨酸氨基转移酶比值、年龄血小板指数、AST/血小板比值指数、γ-谷氨酰转肽酶(GGT)/血小板比值指数、FIB-4、FibroQ、哥德堡大学肝硬化指数、King 评分、GGT/国际标准化比值、血小板与淋巴细胞比值、中性粒细胞与淋巴细胞比值、白细胞与血小板分布宽度比值和平均血小板体积与血小板分布宽度比值(MPV/PDW)进行比较,采用受试者工作特征(ROC)曲线分析。

结果

根据多元逻辑回归分析,ABA 指数的公式为 1.5+(0.065×年龄)+(1.85×胆红素)-(1.65×白蛋白)。根据 ROC 曲线分析,ABA 指数在显著纤维化、严重纤维化和肝硬化的 ROC 曲线下面积(AUROCs)分别为 0.805(95%可信区间 [CI]:0.727-0.883)、0.874(95%CI:0.804-0.943)和 0.895(95%CI:0.828-0.961)。

结论

通过使用 0 和 1 的截断点,ABA 指数被发现优于其他评估慢性丙型肝炎感染患者肝纤维化的非侵入性指数。这些发现应通过前瞻性和多中心研究在慢性丙型肝炎感染患者中得到证实。

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