肝纤维化无创诊断指标在乙型肝炎肝硬化早期患者病情诊断中的应用  

The Application of Non-invasive Diagnostic Index of Hepatic Fibrosis in Early Diagnosis of Hepatitis B Cirrhosis

作　　者：陈斌[1] 朱晓丽[1] 李旺 张庆芳[1] CHEN Bin;ZHU Xiao-li;LI Wang;ZHANG Qing-fang(Taizhou People's Hospital,Taizhou Jiangsu 225300,China)

机构地区：[1]泰州市人民医院,江苏泰州225300

出　　处：《泰州职业技术学院学报》2020年第5期63-66,共4页Journal of Taizhou Polytechnic College

基　　金：泰州市科技支撑计划(社会发展)项目(TS201907,项目主持人:李旺).

摘　　要：目的探讨天冬氨酸转氨酶和血小板比率指数(APRI)、肝纤维化4因子指数(FIB-4)、γ-谷氨酰转肽酶-血小板比值(GPR)、红细胞体积分布宽度-血小板比值(RPR)四种血清肝纤维化无创诊断指标在乙型肝炎肝硬化早期患者病情评估中的作用。方法回顾性分析54例乙型肝炎肝硬化代偿期患者、107例慢性乙型肝炎患者、70例健康体检者,记录AST、ALT、GGT、PDW、PLT等结果,计算APRI、FIB-4、GPR、RPR四种肝纤维化无创诊断指标,并分析其与肝纤维化程度的相关性,结合受试者工作特征曲线(ROC曲线)比较曲线下面积(AUC)评估其在乙型肝炎肝硬化早期诊断中的预测效能。结果肝硬化代偿期组APRI、FIB-4、GPR、RPR和慢性乙肝组APRI、FIB-4、GPR、RPR均与健康对照组差异有统计学意义(P<0.05),肝硬化代偿期组与慢性乙肝组相比APRI、FIB-4、GPR、RPR水平进一步升高(P<0.05);APRI、FIB-4、GPR、RPR与肝纤维化程度呈正相关(P<0.05);在预测乙型肝炎肝硬化的ROC曲线中,APRI、FIB-4、GPR、RPR的AUC分别为0.842、0.887、0.815、0.919,FIB-4与RPR的AUC差异无统计学意义(P>0.05),二者均优于APRI、GPR的AUC,差异有统计学意义(P<0.05)。结论APRI、FIB-4、GPR、RPR可用于乙型肝炎肝硬化早期患者的辅助诊断评估,其快速,方便,诊断效能高,值得在基层推广应用。Objective To explore aspartate aminotransferase and platelet ratio index(APRI), fibrosis 4 score(FIB-4),γ-glutamyl transpeptidase to platelet ratio(GPR), red cell distribution width to platelet ratio(RPR)the role of four serum non-invasive diagnostic indicators of liver fibrosis in the evaluation of early stage patients with hepatitis B virus-related cirrhosis. Methods The retrospective analysis of 54 patients with hepatitis B cirrhosis with compensatory stage, 107 patients with chronic hepatitis B, and 70 healthy medical examiners were conducted to record the results of AST, ALT, GGT, PDW, PLT, etc., and APRI, FIB-4, GPR, RPR four non-invasive diagnostic indicators of liver fibrosis were calculated. Correlation analysis was used to analyze the correlation between APRI, FIB-4, GPR, RPR and the degree of liver fibrosis, combined with the receiver operating characteristic curve(ROC curve)to compare the area under the curve(AUC)Evaluate its predictive efficacy in the diagnosis of hepatitis B virus-related cirrhosis. Results APRI, FIB-4, GPR, RPR in patients with hepatitis B virus-related cirrhosis and APRI, FIB-4, GPR, RPR in patients with chronic hepatitis B were significantly higher than healthy controls APRI, FIB-4, GPR, RPR(P<0.05). The levels of APRI, FIB-4, GPR, and RPR in the hepatitis B virus-related cirrhosis group were further increased compared with the chronic hepatitis B group(P<0.05);APRI, FIB-4, GPR, RPR is positively correlated with the degree of liver fibrosis(P<0.01);In the ROC curve for predict hepatitis B virus-related cirrhosis, the AUC of APRI, FIB-4, GPR, and RPR are0.842, 0.887, 0.815, 0.919, the AUC difference between FIB-4 and RPR was not statistically significant(P>0.05), both of them were significantly greater than the AUC of APRI and GPR(P<0.05). Conclusion APRI,FIB-4, GPR, and RPR can be used in the auxiliary diagnosis and evaluation of early patients with hepatitis B cirrhosis. It is fast, convenient, and has high diagnostic efficiency, and it is worthy of popularization and applicati

关 键 词：乙型肝炎肝硬化 肝纤维化 无创诊断 FIB-4 RPR 

分 类 号：R575.2[医药卫生—消化系统]