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新型纤维化指数与其他非侵入性血清指标预测慢性肝病患者纤维化的比较研究

A Comparative Study of Novel Fibrosis Index and Other Non-invasive Serum Indices for Predicting Fibrosis in Patients of Chronic Liver Disease.

作者信息

Singh Kaustubh, Lamba Mahak, Kumar Vivek, Ahuja Pahul, Gupta K K, Reddy Himanshu, Patwa Ajay, Rungta Sumit, Verma Sudhir

机构信息

Internal Medicine, King George's Medical University, Lucknow, IND.

Gastroenterology, King George's Medical University, Lucknow, IND.

出版信息

Cureus. 2024 Jul 2;16(7):e63658. doi: 10.7759/cureus.63658. eCollection 2024 Jul.

Abstract

Introduction Chronic liver disease progression leads to liver fibrosis/cirrhosis. Transient Elastography is used for staging liver fibrosis but ascites, obesity, and operator experience limit its applicability. In this study, we compared various non-invasive serum indices in predicting fibrosis in chronic liver disease patients. Materials and methods A total of 142 cases of confirmed Chronic Liver Disease were included. Quantitative determination of liver stiffness by Transient Elastography and relevant blood investigations was done. We compared the liver stiffness measurement by Transient Elastography and fibrosis indices, i.e., Aspartate Transaminase (AST) to Alanine Transaminase (ALT) Ratio (AAR), AST to Platelet Ratio Index (APRI), Fibrosis Index (FI), Fibrosis-4 (FIB-4) Index, Age-Platelet Index (API), Pohl score, and Fibrosis Cirrhosis Index (FCI) with Novel Fibrosis Index (NFI), to predict liver fibrosis stages. Results The optimum cutoff of NFI for the F4 stage was ≥ 6670 with a sensitivity of 75.8% and specificity of 81.8%, for the F3 stage was ≥ 2112 with a sensitivity of 63.6% and specificity of 72.7%, and for the F2 stage was ≥ 1334 with a sensitivity of 100% and specificity of 56.3%. The NFI had the maximum area under the curve compared to other indices in predicting fibrosis stages. Conclusion The Novel Fibrosis Index was the best in predicting fibrosis stages in Chronic Liver Disease patients, with good performance in predicting the F4 stage.

摘要

引言 慢性肝病进展会导致肝纤维化/肝硬化。瞬时弹性成像用于肝纤维化分期,但腹水、肥胖和操作者经验限制了其适用性。在本研究中,我们比较了各种非侵入性血清指标在预测慢性肝病患者纤维化方面的作用。材料与方法 共纳入142例确诊的慢性肝病患者。通过瞬时弹性成像进行肝脏硬度的定量测定并进行相关血液检查。我们比较了瞬时弹性成像测量的肝脏硬度与纤维化指标,即天冬氨酸转氨酶(AST)与丙氨酸转氨酶(ALT)比值(AAR)、AST与血小板比值指数(APRI)、纤维化指数(FI)、纤维化-4(FIB-4)指数、年龄-血小板指数(API)、波尔评分和纤维化肝硬化指数(FCI)与新型纤维化指数(NFI),以预测肝纤维化分期。结果 F4期NFI的最佳截断值≥6670,敏感性为75.8%,特异性为81.8%;F3期≥2112,敏感性为63.6%,特异性为72.7%;F2期≥1334,敏感性为100%,特异性为56.3%。在预测纤维化分期方面,NFI与其他指标相比曲线下面积最大。结论 新型纤维化指数在预测慢性肝病患者纤维化分期方面表现最佳,在预测F4期方面性能良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2eaa/11293017/253494555915/cureus-0016-00000063658-i01.jpg

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