慢性HBV感染患者APRI、FIB-4的检测及临床意义  

Detection and clinical significance of APRI and FIB-4 in patients with chronic HBV infection

作　　者：田景波[1] 王丽丽[1] 曲燕[1] 郭善媛[1] 刘建军[1] Tian Jingbo;Wang Lili;Qu Yan;Guo Shanyuan;Liu Jianjun(Second Affiliated Hospital of Medical College of Qingdao University,Qingdao 266042,China)

机构地区：[1]青岛大学医学院第二附属医院,266042

出　　处：《中国综合临床》2019年第1期69-72,共4页Clinical Medicine of China

摘　　要：目的检测慢性HBV感染患者天门冬氨酸氨基转移酶和血小板比率指数(aspartate aminotransferase-to-platelet ratio index,APRI)、基于4因子的纤维化指数(fibrosis index based on the four factors,FIB-4)的数值的变化,分析评估肝功能状态,并探讨临床意义,以便寻求简单易行的肝纤维化无创诊断手段。方法采用临床对照的研究方法,选取青岛大学医学院第二附属医院2016年1月至2017年6月期间门诊和住院的120例不同临床感染状态下的慢性HBV感染患者,分为HBV携带者、慢性乙型肝炎患者以及乙型肝炎肝硬化患者3组,每组40例,检测血清总胆红素、白蛋白、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)和血小板的含量,根据公式计算出APRI和FIB-4的数值,研究其在不同类型慢性HBV感染患者的数值变化。并与总胆红素、白蛋白之间作相关性分析。同时选取30名健康者作为健康对照组进行对照分析。结果慢性HBV感染患者、健康对照组APRI的数值分别为1.17±0.71与0.50±0.23,慢性HBV感染患者、健康对照组FIB-4的数值分别为1.90±0.84与1.08±0.58,差异均有统计学意义(P均<0.01)。HBV携带者组、慢性乙型肝炎组、乙型肝炎肝硬化组患者APRI的数值分别为0.53±0.22、1.14±0.61、1.84±0.49;FIB-4的数值分别为1.22±0.54、1.85±0.48、2.64±0.77。慢性HBV感染各亚组患者APRI、FIB-4的数值,随着肝纤维化程度的的升高而递增,组间比较差异均有统计学意义(P均<0.01);其中乙型肝炎肝硬化组与健康对照组、慢性乙型肝炎组与健康对照组、乙型肝炎肝硬化组与HBV携带者组、慢性乙型肝炎组与HBV携带者组比较差异有统计学意义(P<0.01)。HBV携带者组与健康对照组比较差异无统计学意义(P>0.05)。相关性分析结果显示,慢性HBV感染患者APRI、FIB-4与总胆红素呈正相关性(P均<0.01);与白蛋白呈负相关性(P均<0.01)�Objective To detect the changes of aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on the four factors (FIB-4) in patients with chronic HBV infection, and to analyze and evaluate the status of liver function, and explore the clinical significance in order to find a simple non-invasive diagnostic method for liver fibrosis.Methods From January 2016 to June 2017, a clinical controlled study was conducted to select one hundred and twenty patients with chronic HBV infection in outpatient and inpatient clinics of the Second Affiliated Hospital of Medical College of Qingdao University.They were divided into three groups: HBV carriers, chronic hepatitis B patients and hepatitis B cirrhosis patients.Serum total bilirubin, albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and platelet levels were measured.According to the formula, the values of APRI and FIB-4 were calculated, and the numerical changes of APRI and FIB-4 in patients with different types of chronic HBV infection were studied.The correlation between total bilirubin and albumin was analyzed.At the same time, 30 healthy persons were selected as healthy control group for clinical analysis.Results The APRI values of patients with chronic HBV infection and healthy control group were (1.17±0.71) and (0.50±0.23), respectively.The FIB-4 values of patients with chronic HBV infection and healthy control group were (1.90±0.84) and (1.08±0.58), respectively.The differences were statistically significant (P<0.01). The APRI values of HBV carriers group, chronic hepatitis B group and hepatitis B cirrhosis group were(0.53±0.22), (1.14±0.61) and (1.84±0.49). The values of FIB-4 were (1.22±0.54), (1.85±0.48) and (2.64±0.77) respectively.The values of APRI and FIB-4 of chronic HBV infection patients in each group increased with the increase of liver fibrosis, and there was significant difference between the groups (P<0.01). The results showed that hepatitis B cirrhosis grouP>chronic hepatitis B grouP>HBV carrie

关 键 词：慢性HBV感染 天门冬氨酸氨基转移酶和血小板比率指数 基于4因子的纤维化指数 

分 类 号：R512.62[医药卫生—内科学]