国际标准化比值/血小板比值在评估慢性乙型肝炎病毒感染患者肝纤维化中的效能  

The Efficacy of International Normalized Ratio-to-platelet Ratio in Evaluating Liver Fibrosis in Chronic Hepatitis B Virus Infection

作　　者：杨璐璇 张文勇 刘美琴[1] 沈秀娟[1] YANG Luxuan;ZHANG Wenyong;LIU Meiqin;SHEN Xiujuan(The Affiliated Infectious Diseases Hospital of Soochow University,Suzhou 215000,China;不详)

机构地区：[1]苏州大学附属传染病医院(江苏省苏州市第五人民医院),江苏苏州215000

出　　处：《中国医学创新》2022年第29期34-39,共6页Medical Innovation of China

基　　金：苏州市科技兴卫青年科技项目(KJXW2019047)。

摘　　要：目的:探讨应用国际标准化比值/血小板比值(international normalized ratio-to-platelet ratio,INPR)诊断慢性乙型肝炎病毒(HBV)感染患者肝纤维化的价值。方法:回顾性分析2018年10月-2021年9月在苏州大学附属传染病医院进行肝脏病理检查的187例慢性HBV感染患者的临床资料,根据肝脏病理结果将肝纤维化程度分为S0~S4期,比较INPR与常用的无创肝纤维化诊断模型的差异,分析INPR在诊断慢性乙型病毒感染患者肝纤维化中的价值。结果:不同肝纤维化分期患者的性别和年龄比较,差异均无统计学意义(P>0.05)。不同肝纤维化分期患者的丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转氨酶(AST)、γ-谷氨酰转移酶(γ-GT)、血小板(PLT)、红细胞体积分布宽度(RDW)及国际标准化比值(INR)比较,差异均有统计学意义(P<0.05)。INPR与肝纤维化的相关系数为0.517(P<0.05),高于常用的无创肝纤维化诊断模型[天冬氨酸氨基转移酶和血小板比率指数(APRI)、肝纤维化4因子指数(FIB-4)、γ-GT-PLT比值(GPR)、RDW-PLT比值(RPR)、瞬时弹性成像技术所测量的肝脏硬度(LSM)]。INRP在诊断显著肝纤维化(S≥2)、进展期肝纤维化(S≥3)及肝硬化(S=4)的效能均较好,INPR的AUC分别为0.699、0.834和0.896,均高于其他常用无创诊断模型。结论:相较于目前常用的无创肝纤维化诊断模型,INPR对慢性乙型肝炎病毒感染患者肝纤维化的诊断效能更佳,可考虑将该模型推广于临床工作,以提升对肝纤维化的无创诊断水平。Objective:To evaluate the value of international normalized ratio-to-platelet ratio(INPR)in diagnosing liver fibrosis in chronic hepatitis B virus(HBV)infection.Method:The clinical data of 187 patients with chronic HBV infection who underwent liver pathological examination in the Affiliated Infectious Diseases Hospital of Soochow University from October 2018 to September 2021 were retrospectively analyzed,according to the liver pathological results,the degree of liver fibrosis was divided into S0 to S4 stages,and the differences between INPR and commonly used non-invasive liver fibrosis diagnostic models in each stage were compared,the value of INPR in the diagnosis of liver fibrosis in patients with chronic B virus infection were analyzed.Result:There were no significant differences in gender and age among patients with different stages of liver fibrosis(P>0.05).There were statistically significant differences in alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyltransferase(γ-GT),platelet(PLT),red cell distribution width(RDW)and international normalized ratio(INR)in patients with different liver fibrosis stages(P<0.05).The correlation coefficient between INPR and liver fibrosis was 0.517(P<0.05),which were higher than the commonly used non-invasive diagnostic model of liver fibrosis[aspartate aminotransferase-to-platelet ratio index(APRI),fibrosis-4 index(FIB-4),γ-GT-PLT ratio(GPR),RDW-PLT ratio(RPR),liver stiffness measurement(LSM)by transient elastography].INRP had a good performance in the diagnosis of significant liver fibrosis(S≥2),advanced liver fibrosis(S≥3)and cirrhosis(S=4),and the AUC of INPR was 0.699,0.834 and 0.896,respectively,which were higher than other commonly used noninvasive diagnostic models.Conclusion:Compared with the currently commonly used noninvasive liver fibrosis diagnostic models, INPR has a better diagnostic efficiency for liver fibrosis in chronic hepatitis B virus infection. It can be extended to clinical work to enhance the level of noninvasive diagno

关 键 词：国际标准化比值 血小板 肝纤维化 乙型肝炎病毒 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]