Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China.
Int J Med Sci. 2021 Jan 9;18(5):1159-1166. doi: 10.7150/ijms.51799. eCollection 2021.
We aimed to investigate whether a novel noninvasive index, i.e., the international normalized ratio-to-platelet ratio (INPR), was a variable in determining liver fibrosis stage in patients with chronic hepatitis B (CHB). A total of 543 treatment-naïve CHB patients were retrospectively enrolled. Liver histology was assessed according to the Metavir scoring scheme. All common demographic and clinical parameters were analyzed. Based on routine clinical parameters (age, sex, HBeAg status, HBV DNA, hematological parameters, coagulation index, and liver biochemical indicators), a novel index, i.e., the INR-to-platelet ratio (INPR), was developed to magnify the unfavorable effects of liver fibrosis on INR and platelets. The AUCs of INPR for predicting significant fibrosis, advanced fibrosis, and cirrhosis were 0.74, 0.76 and 0.86, respectively. Compared with APRI, FIB-4, and GPR, the INPR had comparable predictive efficacy for significant fibrosis and better predictive performance for advanced fibrosis and cirrhosis. INPR could be an accurate, easily calculated and inexpensive index to assess liver fibrosis in patients with CHB. Further studies are needed to verify this indicator and compare it with other noninvasive methods for predicting liver fibrosis in CHB patients.
我们旨在研究一种新的非侵入性指数，即国际标准化比值-血小板比值（INPR），是否可以作为判断慢性乙型肝炎（CHB）患者肝纤维化分期的指标。共回顾性纳入了 543 例初治 CHB 患者。采用 Metavir 评分系统评估肝组织学。分析了所有常见的人口统计学和临床参数。基于常规临床参数（年龄、性别、HBeAg 状态、HBV DNA、血液学参数、凝血指数和肝功能指标），开发了一种新的指数，即国际标准化比值-血小板比值（INPR），以放大肝纤维化对 INR 和血小板的不利影响。INPR 预测显著纤维化、进展性纤维化和肝硬化的 AUC 分别为 0.74、0.76 和 0.86。与 APRI、FIB-4 和 GPR 相比，INPR 对显著纤维化具有相当的预测效果，对进展性纤维化和肝硬化具有更好的预测性能。INPR 可能是一种准确、易于计算且廉价的指数，可用于评估 CHB 患者的肝纤维化。需要进一步的研究来验证该指标，并与其他用于预测 CHB 患者肝纤维化的非侵入性方法进行比较。
