白蛋白和Ⅳ型胶原及脾长径评分系统对慢性乙型肝炎肝纤维化分期的诊断意义  

Scoring system composed of albumin,collagen Ⅳ and longitudinal diameter of spleen for diagnosis of liver fibrosis in hepatitis B patients

作　　者：黄湛镰[1] 彭亮[1] 郑玉宝[1] 高志良[1] 崇雨田[1] 赵志新[1] 

机构地区：[1]中山大学附属第三医院感染科,广州510630

出　　处：《中华实验和临床感染病杂志（电子版）》2011年第4期18-22,共5页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：中山大学5010计划资助项目(2007029);广东省艾滋病;病毒性肝炎社区综合防治研究资助项目(2009ZX1001-018)

摘　　要：目的从常用的非创伤性指标中筛选出与肝纤维化分期相关的指标,并进一步建立评分系统用于慢性乙型肝炎肝纤维化的诊断。方法收集208例慢性乙型肝炎患者的33项非创伤性指标值,分析这些指标与纤维化分期的关系,筛选与肝纤维化分期相关的指标,继续用Bayes逐步判别并分析筛选出具有判别作用的指标,从中选取代表性较强的指标以建立评分系统用于肝纤维化分期的诊断,并验证此评分系统的敏感性及特异性。结果通过相关分析,共筛选出20项与肝纤维化分期相关的指标,继续用Bayes逐步判别分析并筛选出白蛋白、Ⅳ型胶原及脾长径建立评分系统,取总分4分为诊断截断值,以该评分系统区分S0～2及S3～4纤维化的符合率为70.9%,诊断S3～4纤维化组的灵敏度和特异度分别为69.7%和71.7%。结论白蛋白、Ⅳ型胶原及脾长径3项指标组成的评分系统可以较好地区分S1～2及S3～4肝纤维化,符合率为70.9%。Objective To screen the noninvasive indexes correlated to liver fibrosis and establish scoring system for the diagnosis of liver fibrosis in hepatitis B patients.Methods Data of 33 noninvasive indexes in 208 hepatitis B patients were collected and indexes correlated to liver fibrosis were screened out.Then stepwise discriminant analysis was applied to screen out the indexes useful for the diagnosis of liver fibrosis.A scoring system composed of indexes screened out by stepwise discriminant analysis was established for the diagnosis of live fibrosis.Results Twenty indexes correlated to liver fibrosis were screened out.A scoring system composed of albumin,collagen Ⅳ and longitudinal diameter of spleen was established.The diagnostic coincidence rate for distinguishing S0-2 and S3-4 patients with liver fibrosis through this scoring system was 70.9%.The sensitivity and specificity for diagnosis of S3-4 fibrosis were 69.7% and 71.7%,respectively.Conclusions The scoring system consisted of albumin,collagen Ⅳ and longitudinal diameter of spleen provides a more simpler method to distinguish S1-2 and S3-4 patients with liver fibrosis.The diagnostic coincidence rate for distinguishing S0-2 and S3-4 patients with liver fibrosis through this scoring system is 70.9%.

关 键 词：肝炎 乙型 慢性 肝纤维化 非创伤性指标 评分系统 

分 类 号：R575.2[医药卫生—消化系统]