Zhang Xiujuan, Jie Yusheng, Wan Zemin, Lin Shanshan, Li Yingxian, Lin Ming, Wu Shuduo, Wu Xiaoju, Shi Meijie, Xiao Huanming, Cao Minling, Gong Jiao, Chi Xiaoling
Department of Hepatology Diseases, Guangdong Provincial Hospital of Chinese Medicine Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Front Pharmacol. 2021 Nov 10;12:653751. doi: 10.3389/fphar.2021.653751. eCollection 2021.
Diagnosis of significant liver fibrosis is essential to facilitate the optimal treatment decisions and improve prognosis in patients with chronic hepatitis B (CHB). We aimed to evaluate the value of inflammatory indicators and construct a nomogram that effectively predicts significant liver fibrosis among CHB patients. 563 CHB patients from two centers in China from 2014 to 2019 were divided into three cohorts (development, internal validation, and independent validation cohorts), assigned into cases with significant fibrosis (liver fibrosis stages ≥2) and those without. Multiple biochemical and serological inflammatory indicators were investigated. Inflammatory indicators, Alanine aminotransferase (ALT) and aspartate aminotransferase (AST), were significantly associated with significant liver fibrosis in CHB patients but limited predictive performance, and then we combined them with prothrombin time activity percentage (PTA) and liver stiffness measurement (LSM) were identified by multivariate logistic regression analysis. Based on these factors, we constructed the nomogram with excellent performance. The area under the receiver operating characteristic curve (AUROC) for the nomogram in the development, internal validation, and independent validation cohorts were 0.860, 0.877, and 0.811, respectively. Our nomogram based on ALT and AST that had excellent performance in predicting significant fibrosis of CHB patients were constructed.
诊断显著肝纤维化对于促进慢性乙型肝炎（CHB）患者的最佳治疗决策和改善预后至关重要。我们旨在评估炎症指标的价值，并构建一个能有效预测CHB患者显著肝纤维化的列线图。2014年至2019年来自中国两个中心的563例CHB患者被分为三个队列（开发队列、内部验证队列和独立验证队列），分为有显著纤维化（肝纤维化分期≥2）和无显著纤维化的病例。研究了多种生化和血清学炎症指标。炎症指标谷丙转氨酶（ALT）和谷草转氨酶（AST）与CHB患者的显著肝纤维化显著相关，但预测性能有限，然后我们将它们与凝血酶原时间活动度百分比（PTA）和肝脏硬度测量值（LSM）相结合，通过多因素逻辑回归分析确定。基于这些因素，我们构建了性能优异的列线图。该列线图在开发队列、内部验证队列和独立验证队列中的受试者操作特征曲线下面积（AUROC）分别为0.860、0.877和0.811。我们构建了基于ALT和AST且在预测CHB患者显著纤维化方面具有优异性能的列线图。
