天门冬氨酸转氨酶-血小板比值指数、γ -谷氨酰转肽酶-血小板比值和纤维化-4对代偿性乙型肝炎相关性肝硬化的诊断和预后价值

Pub Date : 2023-08-01 DOI:10.29271/jcpsp.2023.08.941
Jianan Tao, Wenqian Li, Xiuwen Ma, Shunyu Kong, Qi An, Xuehong Wang
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引用次数: 0

摘要

本研究的目的是探讨一种血清诊断模型作为替代肝硬度测量(LSM)诊断代偿性肝硬化(LC)。这项回顾性研究包括150例代偿性乙型肝炎相关LC患者和153例慢性乙型肝炎病毒(HBV)感染患者。该研究于2017年5月至2022年6月在中国青海大学附属医院进行。评估所有入院患者的LSM、天冬氨酸转氨酶血小板比值指数(APRI)、γ -谷氨酰转肽酶血小板比值(GPR)和纤维化-4 (FIB-4)值。采用受试者工作特征(ROC)曲线评价APRI、GPR、FIB-4和LSM的诊断价值。FIB-4评分(AUC=0.842;特异性= 77.8%;敏感性= 80.7%;在3种血清评分模型中,cut-off=2.824)是LSM的最佳替代品。Cox回归模型显示FIB-4评分≥2.824是代偿性乙型肝炎相关LC预后的独立预测因子(HR=1.15, 95%CI: 1.07-1.23, p
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Diagnostic and Prognostic Value of Aspartate Transaminase-to-platelet Ratio Index, Gamma-glutamyl Transpeptidase-to-platelet Ratio, and Fibrosis-4 for Compensated Hepatitis B-related Liver Cirrhosis.

The aim of this study was to investigate a serodiagnostic model as a substitute for liver stiffness measurement (LSM) for diagnosing compensated liver cirrhosis (LC). This retrospective study included 150 patients with compensated hepatitis B-related LC and 153 with chronic Hepatitis B virus (HBV) infection. It was conducted from May 2017 to June 2022 at Qinghai University Affiliated Hospital, China. The values of LSM, aspartate transaminase-to-platelet ratio index (APRI), gamma-glutamyl transpeptidase-to-platelet ratio (GPR), and fibrosis-4 (FIB-4) were evaluated in all admitted patients. The diagnostic value of APRI, GPR, FIB-4, and LSM was assessed using the receiver operating characteristic (ROC) curve. FIB-4 score (AUC=0.842; specificity=77.8%; sensitivity=80.7%; cut-off=2.824) was the best substitute for LSM from the three serum scoring models. The Cox regression model indicated that a FIB-4 score ≥2.824 was an independent predictor of prognosis for compensated hepatitis B-related LC (HR=1.15, 95%CI: 1.07-1.23, p<0.001). This study's findings suggested that FIB-4 could be the best substitute for LSM and may help to assess LC prognosis. Key Words: APRI, GPR, FIB-4, LSM, Diagnosis, Liver cirrhosis.

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