Luo Xin, Li Jichang, Ma Yi'an, Yang Lingling, Ma Naqi
Department of Gastroenterology, Baoji Central Hospital Baoji 721000, Shaanxi, China.
Am J Transl Res. 2025 Aug 15;17(8):5949-5961. doi: 10.62347/KKMB6772. eCollection 2025.
To evaluate the clinical relevance of the Albumin Ratio (AR) and Liver-to-Abdominal Area Ratio (LAAR) as prognostic markers for patients with hepatitis B-related cirrhosis.
A retrospective cohort study was conducted on 278 patients diagnosed with hepatitis B-associated cirrhosis at Baoji Central Hospital from January 2017 to December 2020. Clinical data, laboratory results (AR), and imaging data (LAAR) were collected. Prognostic value of AR and LAAR was assessed using Kaplan-Meier survival analysis, Cox proportional hazards regression, and receiver operating characteristic (ROC) curves. A nomogram integrating multiple variables was developed and validated to dynamically predict 6-, 12-, and 24-month survival outcomes.
Both AR and LAAR were significantly reduced in the deceased group compared to survivors (P<0.05). Cox regression analysis identified AR (HR=1.86, 95% CI: 1.40-2.45, P<0.001) and LAAR (HR=1.67, 95% CI: 1.25-2.22, P=0.002) as independent prognostic factors. Kaplan-Meier survival curves revealed significantly shorter survival in patients with lower AR and LAAR (P<0.001). Time-dependent ROC analysis indicated good predictive performance for AR (AUC up to 0.85), while LAAR showed relatively low discrimination, with AUCs ranging from 0.507 to 0.623. The nomogram, incorporating both AR and LAAR, exhibited excellent discrimination (C-index =0.950), and its predictive accuracy was validated through calibration curves.
AR and LAAR are critical prognostic indicators in hepatitis B-related cirrhosis. The nomogram model, integrating these values, supports tailored treatment plans and monitoring strategies in clinical settings. Patients with lower AR and LAAR have poorer survival outcomes, and the model's robust predictive capacity has been validated, enhancing precision in patient management and supporting individualized therapeutic decisions.
评估白蛋白比值（AR）和肝脏与腹部面积比值（LAAR）作为乙型肝炎相关肝硬化患者预后标志物的临床相关性。
对2017年1月至2020年12月在宝鸡市中心医院确诊为乙型肝炎相关性肝硬化的278例患者进行回顾性队列研究。收集临床资料、实验室检查结果（AR）和影像学资料（LAAR）。采用Kaplan-Meier生存分析、Cox比例风险回归和受试者工作特征（ROC）曲线评估AR和LAAR的预后价值。构建并验证了一个整合多个变量的列线图，以动态预测6个月、12个月和24个月的生存结局。
与存活者相比，死亡组的AR和LAAR均显著降低（P<0.05）。Cox回归分析确定AR（HR=1.86，95%CI：1.40-2.45，P<0.001）和LAAR（HR=1.67，95%CI：1.25-2.22，P=0.002）为独立预后因素。Kaplan-Meier生存曲线显示，AR和LAAR较低的患者生存时间显著缩短（P<0.001）。时间依赖性ROC分析表明AR具有良好的预测性能（AUC高达0.85），而LAAR的鉴别能力相对较低，AUC范围为0.507至0.623。整合了AR和LAAR的列线图具有出色的鉴别能力（C指数=0.950），其预测准确性通过校准曲线得到验证。
AR和LAAR是乙型肝炎相关肝硬化的关键预后指标。整合这些值的列线图模型有助于在临床环境中制定个性化的治疗方案和监测策略。AR和LAAR较低的患者生存结局较差，该模型强大的预测能力已得到验证，提高了患者管理的精准度并支持个体化治疗决策。
