APRI指数对慢性乙型肝炎患者肝纤维化程度的评估价值及临床特征的相关性研究  

Study on the Value of APRI in Assessing the Degree of Liver Fibrosis In Patients with Chronic Hepatitis B and its Correlation with Clinical Features

作　　者：王鸣 杨双双 郭威[1] 邢铭友[1] 宋建新[1] WANG Ming;YANG Shuang-shuang;GUO Wei;XING Ming-you(Department of Infectious Disease,Tongfi Hospital,Tongfi Med-ical College,Huazhong University of Science and Technology（Wuhan Hubei,430030）China)

机构地区：[1]华中科技大学同济医学院附属同济医院感染科,湖北武汉430030

出　　处：《中西医结合肝病杂志》2018年第5期283-285,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：湖北省卫生计生委面上项目(No.WJ2017M068)

摘　　要：目的:探讨慢性乙型肝炎患者天门冬氨酸氨基转移酶/血小板比值指数(APRI)对肝脏纤维化的评估价值,观察APRI与慢性乙型肝炎相关临床特征的关系,旨在为临床患者病情判定及治疗提供依据。方法:收集2014年1月1日至2016年12月31日在武汉同济医院感染科住院的慢性乙型肝炎患者113例,所有病例均行肝脏彩超或CT检查,同时检测血常规、肝肾功能、凝血功能等,计算出APRI,评估APRI对判断肝纤维化程度的价值。根据APRI将患者分为无肝硬化组(APRI≤2)、肝硬化组(APRI﹥2. 0),比较两组患者血常规(WBC、RBC、PLT)、肝功能(AST、ALT)、肾功能(BUN、s Cr、e GFR)、凝血功能(PT、APTT)、脾脏大小、腹水情况。结果:随着疾病的进展,APRI随之升高。无肝硬化组患者WBC、RBC、PLT高于肝硬化组(P <0. 05); AST、ALT水平及PT、APTT水平均显著低于肝硬化组(P <0. 05);肝硬化组脾脏肿大的比例高于无肝硬化组(P <0. 05),两组患者肾功能及腹水情况均无统计学差异。结论:作为非侵袭性诊断肝纤维化的手段之一,APRI可用于评估肝纤维化程度,此外,APRI与慢性乙型肝炎患者的相关临床特征有相关性,对临床病情的判断有一定的价值。Objective：To explore the value of APRI in assessing the degree of liver fibrosis in patients with chronic hepatitis B and ob- serve the relationship between APRI and the clinical features of chronic hepatitis B, in order to provide evidence for assessment and treatment of clinical conditions, nethods：A total of 113 patients with chronic hepatitis B who were hospitalized in Department of Infectious Disease of Wuhan Tongji Hospital from January 1,2014 to December 31,2016 were em＇olled in this study. All patients underwent color Doppler ultra- sonography or CT examination of livers. At the same time, routine blood test, hepatic and renal function tests and coagulation function test were also performed , and then the APRI was calculated and the value of APRI in assessing the degree of liver fibrosis was estimated. The pa- tients were divided into non - cirrhosis group （ APRI ~〈 2） and cirrhosis group （ APRI 〉 2.0） according to APRI, and the differences in re- suhs of routine blood test （WBC, RBC and PLT）, hepatic function test （AST and ALT）, renal function test （BUN, SCr and eGFR）, coagula- tion function test （PT and APTT）, spleen size and ascites status were compared between two groups. Results：As the disease progressed, the APRI increased. WBC, RBC and PLT in the non - cirrhosis group were higher than those in the cirrhosis group （P 〈 0.05 ） ; AST and ALT levels as well as PT and APTT levels in the non - cirrhosis group were significantly lower than those in the cirrhosis group （P 〈 0.05 ） ; the proportion of patients with spleen enlargement in the cirrhosis group was higher than that in the non - cirrhosis group （P 〈 0.05）. There were no statistical differences in renal function and ascites status between the two groups. Conclusion：As one of noninvasive diagnostic means of liver fibrosis, APRI can be used to assess the degree of liver fibrosis. In addition,the APRI is correlated with the clinical features of patients with chronic hepatitis B and has a certain

关 键 词：慢性乙型肝炎 肝纤维化 天门冬氨酸氨基转移酶/血小板比值指数 

分 类 号：R512.62[医药卫生—内科学]