Department of Internal Medicine, University of Health Sciences - Adana City Research and Training Hospital, Adana, Turkey.
Department of Gastroenterology, University of Health Sciences - Adana City Research and Training Hospital, Adana, Turkey.
Ethiop J Health Sci. 2023 Jul;33(4):591-600. doi: 10.4314/ejhs.v33i4.5.
There are studies on the determination of hepatic fibrosis with noninvasive markers but data about liver biopsy results and noninvasive markers in patients with chronic hepatitis B (CHB) are limited. The aim of this study is to determine the relationship between pathological findings and noninvasive markers, and to determine the marker that predicts fibrosis in patients with consistently normal serum alanine aminotransferase (ALT) levels, diagnosed with CHB and undergoing liver biopsy.
A total of 122 patients with CHB, 29 of them with HbeAg (+), aged 30 years and older, HBV DNA > 2000 IU / ml, and serum ALT levels measured four times in the last year, were consistently normal, and 93 of them with HbeAg (-) were included in the study. Demographic characteristics of patients, laboratory parameters, histological activity index (HAI) and fibrosis values obtained in liver biopsy, and noninvasive markers (AP (age-platelet) index, APRI (AST/Platelet ratio) and FIB-4 score, neutrophil/lymphocyte ratio, mean platelet volume (MPV) and erythrocyte distribution width (RDW) were recorded.
The relationship between RDW value and fibrosis was statistically significant in the HbeAg (+) group (p<0.001). The relationship between AP index, APRI and FIB-4 score, neutrophil/lymphocyte ratio and MPV with fibrosis was not statistically significant (>0.05 for each).
It has been shown that the RDW value can be used to predict fibrosis in CHB patients with normal ALT and HbeAg (+), and the cut-off value for RDW is 12.
有研究使用非侵入性标志物来确定肝纤维化，但关于慢性乙型肝炎（CHB）患者的肝活检结果和非侵入性标志物的数据有限。本研究旨在确定病理发现与非侵入性标志物之间的关系，并确定在持续正常血清丙氨酸氨基转移酶（ALT）水平、诊断为 CHB 并接受肝活检的患者中预测纤维化的标志物。
共纳入 122 例 CHB 患者，其中 29 例 HbeAg（+），年龄≥30 岁，HBV DNA>2000 IU/ml，过去一年测量了 4 次血清 ALT 水平均正常，其中 93 例 HbeAg（-）纳入研究。记录患者的人口统计学特征、实验室参数、肝活检获得的组织学活动指数（HAI）和纤维化值，以及非侵入性标志物（AP（年龄-血小板）指数、APRI（AST/血小板比值）和 FIB-4 评分、中性粒细胞/淋巴细胞比值、平均血小板体积（MPV）和红细胞分布宽度（RDW）。
HbeAg（+）组中 RDW 值与纤维化之间存在统计学显著关系（p<0.001）。AP 指数、APRI 和 FIB-4 评分、中性粒细胞/淋巴细胞比值和 MPV 与纤维化之间的关系无统计学意义（p>0.05）。
研究表明，RDW 值可用于预测 ALT 正常且 HbeAg（+）的 CHB 患者的纤维化，RDW 的截断值为 12。
