APRI和FIB4在慢性丙型肝炎肝纤维化诊断中的应用  

Application of APRI and FIB4 in the diagnosis of liver fibrosis in chronic hepatitis C

作　　者：叶向阳[1] 邱荣仙[1] 何雄志[1] 胡震霆[1] 郑锋锋 黄晓刚[1] 黄庆华[1] 林国贤[1] YE Xiangyang;QIU Rongxian;HE Xiongzhi;HU Zhenting;ZHENG Fengfeng;HUANG Xiaogang;HUANG Qinghua;LIN Guoxian(Department of Infectious Disease,the Affiliated Hospital of Putian College,Putian,Fujian,China,351100)

机构地区：[1]莆田学院附属医院感染性疾病科,福建莆田351100

出　　处：《分子诊断与治疗杂志》2020年第12期1657-1660,共4页Journal of Molecular Diagnostics and Therapy

基　　金：莆田市科技计划项目(2018S3F001)。

摘　　要：目的探讨血清学诊断指标[天门冬氨酸氨基转移酶与血小板比值指数(APRI)、基于4因子的肝纤维化指数(FIB4)]在诊断慢性丙型肝炎(CHC)肝纤维化程度中的应用价值。方法选取接受肝组织病理检查的CHC患者317例,根据肝纤维化分期S0、S1、S2、S3、S4期,分成5组,检测ALT、AST、PLT水平;根据(AST/40μ/L)×100/PLT(10~9/L)和(年龄×AST)/(PLT×ALT的平方根)公式分别计算APRI和FIB4值,分析其与肝纤维化程度的相关性。结果 APRI值在肝纤维化S0、S1、S2、S3、S4期中位数(四分位间距)分别为0.34(0.49)、0.47(0.66)、0.56(0.61)、0.68(0.80)、0.93(1.45)(P<0.05);FIB4值在S0、S1、S2、S3、S4期中位数(四分位间距)分别为1.58(1.10)、1.58(1.74)、2.15(1.65)、2.99(2.51)、3.56(4.09)(P<0.05)。Spearman相关性分析显示APRI和FIB4与肝纤维化分期显著相关(P<0.05)。结论APRI和FIB4在诊断CHC患者肝纤维化程度中具有较高预测价值。Objective To explore the diagnostic value of the aspartate aminotransferase⁃platelet ra⁃tio index(APRI)and fibrosis index based on 4 factor(FIB4)in the chronic hepatitis C(CHC)patients with liv⁃er fibrosis.Methods A total of 317 patients with CHC who underwent liver pathological examination were se⁃lected and divided into 5 groups according to liver fibrosis stages S0,S1,S2,S3,and S4.Then the levels of ALT,AST and PLT were detected and calculated APRI and FIB4 values,according to the formulas:(AST/40μ/L)×100/PLT(109/L)and(age×AST)(/PLT×ALT square root),respectively.The correlation between the APRI and FIB4 values and the degree of liver fibrosis were analyzed.Results Statistical analysis showed that the median(interquartile range)APRI values of S0,S1,S2,S3,and S4 in liver fibrosis were 0.34(0.49),0.47(0.66),0.56(0.61),0.68(0.80),and 0.93(1.45),respectively(P<0.05).The median(interquartile range)values of FIB4 in S0,S1,S2,S3,and S4 were 1.58(1.10),1.58(1.74),2.15(1.65),2.99(2.51),and 3.56(4.09),respectively(P<0.05).Spearman correlation analysis showed that APRI and FIB4 were signif⁃icantly related to liver fibrosis stages(P<0.05).Conclusion APRI and FIB4 have high predictive value in the diagnosis of liver fibrosis stages in patients with CHC.

关 键 词：慢性丙型肝炎 天门冬氨酸氨基转移酶与血小板比值指数 基于4因子的肝纤维化指数 血小板计数 肝纤维化 

分 类 号：R512.63[医药卫生—内科学] R575.2[医药卫生—临床医学]