血小板、天冬氨酸转氨酶、肿瘤坏死因子-α:诊断肝纤维化分期的实验室指标

Shchekotova Ap, I. Bulatova, D. Sosnin, Y. Tretyakova
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摘要

的目标。探讨血小板计数、天冬氨酸转氨酶、肿瘤坏死因子-α值在慢性丙型肝炎肝纤维化严重程度评价中的意义,并建立肝纤维化指数计算公式。材料和方法。本研究包括70例慢性丙型肝炎患者和30例健康人。超声弹性成像估计肝脏密度。超声弹性图显示纤维化分期与血小板计数(r=0.83)、天冬氨酸转氨酶(r=0.83)、肿瘤坏死因子-α (r=0.81)有较强相关性。确定排除肝纤维化实验室检查的最佳分离点为:血小板计数>270×109 /L(检测灵敏度为96.2%),天冬氨酸转氨酶水平2.5对应严重纤维化/肝硬化(F3-4),诊断灵敏度为83%,特异性为78%。血小板计数、天冬氨酸转氨酶和肿瘤坏死因子-α水平、纤维化指数、实验室检测数据可用于慢性丙型肝炎患者的纤维化排除和肝纤维化分期的划分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PLATELETS, ASPARTATE AMINOTRANSFERASE, TUMOR NECROSIS FACTOR-α: LABORATORY PANEL FOR DIAGNOSIS OF LIVER FIBROSIS STAGE
Aim. To study significance of platelet count and values of aspartate aminotransferase and tumor necrosis factor-α in the evaluation of the severity of liver fibrosis in chronic hepatitis C and for the development of fibrosis index calculation formula.Material and Methods. The study included 70 patients with chronic hepatitis C end 30 healthy persons. Liver density was estimated by ultrasound elastography.Results. The correlation analysis revealed strong relationships between the ultrasound elastography findings of fibrosis stage and the platelet count (r=0.83), aspartate aminotransferase (r=0.83), and tumor necrosis factor-α (r=0.81). The optimal separation points of laboratory tests for fibrosis exclusion were identified as follows: platelet count>270×109 /L (test sensitivity=96.2%), aspartate aminotransferase level<44 E/L (sensitivity=96.2%), and tumor necrosis factor-α concentration below 1.9 pg/mL (sensitivity=92.3%). The obtained values of laboratory parameters were used for calculation of the liver fibrosis index. The value of the fibrosis index ranging between 0 and 0.5 indicated the absence of fibrosis (stage F0), the value of the fibrosis index ranging between 0.6 and 2.5 corresponded to the moderate stage of fibrosis (F1-2), and the value of the fibrosis index>2.5 corresponded to the severe fibrosis/cirrhosis of the liver (F3-4) with diagnostic sensitivity of 83% and specificity of 78%.Conclusion. Platelet count, the values of aspartate aminotransferase and tumor necrosis factor-α levels, fibrosis index, and laboratory test data can be used for ruling out fibrosis in chronic hepatitis C patients as well as for stratification of liver fibrosis stages.
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