AAR和APRI对成年慢性丙型肝炎患者肝纤维化的诊断价值  

Diagnostic value of AAR and APRI for liver fibrosis in adult patients with chronic hepatitis C

作　　者：赵雨来[1,2] 赵景民[2] 周光德[2] 孙艳玲[2] 魏来[3] 刘树红[2] 郭小东[2] 杨建法[2] 

机构地区：[1]军事医学科学院,北京100850 [2]解放军第三0二医院病理科,北京100039 [3]北京大学人民医院,100044

出　　处：《传染病信息》2010年第2期101-103,共3页Infectious Disease Information

基　　金：国家"十一五"科技重大专项(2008ZX10002-013)

摘　　要：目的探讨AST/ALT比值(AST/ALT ratio,AAR)和AST/PLT比值指数(AST/PLT ratio index,APRI)对成年慢性丙型肝炎(丙肝)患者肝纤维化的诊断价值。方法选择98例成年慢性丙肝患者进行回顾性分析。对所有患者进行肝脏穿刺活体组织检查以确定肝纤维化分期,比较分析AAR和APRI与肝纤维化分期的关系。结果 AAR只在S0期与S1～S4期患者之间差异有统计学意义(P<0.05),在S0～S1期与S2～S4期、S0～S2期与S3～S4期、S0～S3期与S4期患者之间差异无统计学意义(P均>0.05);APRI在S0期与S1～S4期、S0～S1期与S2～S4期、S0～S2期与S3～S4期、S0～S3期与S4期患者之间差异均有统计学意义(P<0.05)。受试者工作特征曲线分析显示,AAR诊断S1期、S2～S3期和S4期的曲线下面积均<0.7,而APRI均>0.7。APRI诊断S1期、S2～S3期和S4期的诊断界值分别为0.150、0.195和0.245。结论对于成年慢性丙肝患者肝纤维化分期的判定,APRI比AAR更具有参考价值,APRI可以用于S1期、S2～S3期和S4期的诊断。Objective To evaluate the diagnostic value of AST/ALT ratio （AAR） and AST/PLT ratio index （APRI） for liver fibrosis in adult patients with chronic hepatitis C. Methods A total of 98 adult patients with chronic hepatitis C were retrospectively studied. All the patients underwent liver biopsy to evaluate liver fibrosis stage. AAR and APRI were compared by analyzing their correlation with liver fibrosis stage. Results AAR was significantly different between patients with stage 0 fibrosis （group SO） and those with stage 1-4 fibrosis （group S1-4） （P〈0.05）, and it was not significantly different between patients with stage 0-1 fibrosis （group S0-1） and those with stage 2-4 fibrosis （group S2-4）, patients with stage 0-2 fibrosis （group S0-2） and those with stage 3--4 fibrosis （group S3-4）, patients with stage 0-3 fibrosis （group S0-3） and those with stage 4 fibrosis （group S4） （P〉0.05）. APRI was significantly different between group SO and S1-4, group S0-1 and S2-4, group S0-2 and S3-4, and group S0-3 and S4 （P〈0.05）. The receiver operating characteristic curve analysis showed that the areas under curve of AAR for predicting fibrosis S1, $2-3 and $4 were less than 0.7, while those of APRI were more than 0.7. The cutoff points of APRI chosen to predict fibrosis S1,S2-3 and S4 were 0.150, 0.195 and 0.245, respectively. Conclusions APRI is more valuable than AAR for distinguishing liver fibrosis stage of adult patients with chronic hepatitis C. APRI can discriminate fibrosis S1, S2-3 and S4.

关 键 词：肝炎 丙型 丙氨酸转氨酶 天冬氨酸氨基转移酶类 血小板计数 病理学 

分 类 号：R512.63[医药卫生—内科学]