[1]叶 亮,赵永忠.FIB-4、APRI及肝纤维指标对乙型肝炎肝硬化的诊断价值[J].医学信息,2021,34(05):85-88.[doi:10.3969/j.issn.1006-1959.2021.05.024]
　YE Liang,ZHAO Yong-zhong.The Diagnostic Value of FIB-4,APRI and Liver Fiber Indexes in Hepatitis B Liver Cirrhosis[J].Medical Information,2021,34(05):85-88.[doi:10.3969/j.issn.1006-1959.2021.05.024]
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FIB-4、APRI及肝纤维指标对乙型肝炎肝硬化的诊断价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年05期
页码:
85-88
栏目:
论著
出版日期:
2021-03-01

文章信息/Info

Title:
The Diagnostic Value of FIB-4,APRI and Liver Fiber Indexes in Hepatitis B Liver Cirrhosis
文章编号:
1006-1959（2021）05-0085-04
作者:
叶 亮; 赵永忠
（1.广西医科大学附属柳州市人民医院消化内科，广西 柳州 545000； 2.桂林医学院附属医院消化内科，广西 桂林 541001）
Author(s):
YE Liang; ZHAO Yong-zhong
(1.Department of Gastroenterology,Liuzhou People’s Hospital Affiliated to Guangxi Medical University,Liuzhou 545000,Guangxi,China; 2.Department of Gastroenterology,Affiliated Hospital of Guilin Medical University,Guilin 541001,Guangxi,China）
关键词:
慢性乙型肝炎; 肝硬化; 特异度; 肝纤维化
Keywords:
Chronic hepatitis B; Liver cirrhosis; Specificity; Liver fibrosis
分类号:
R575
DOI:
10.3969/j.issn.1006-1959.2021.05.024
文献标志码:
A
摘要:
目的 分析基于4因子的纤维化指数（FIB-4）、天门冬氨酸氨基转移酶/血小板比值（APRI）、血清Ⅳ型胶原（CⅣ）、层黏连蛋白（LN）与乙型肝炎肝硬化的关系，观察其对乙型肝炎肝硬化的诊断价值。方法 收集2018年10月~2020年6月广西医科大学附属柳州市人民医院消化内科及感染性疾病科、桂林医学院附属医院消化内科收治的慢性乙型肝炎、乙型肝炎肝硬化患者260例作为研究对象，其中128例慢性乙型肝炎患者作为慢性乙型肝炎组，132例乙型肝炎肝硬化患者作为乙型肝炎肝硬化组，比较两组年龄、谷草转氨酶（ALT）、谷丙转氨酶（AST）、血小板（PLT）、FIB-4、APRI、CⅣ及LN水平，分析上述指标与发生肝硬化的关系，绘制ROC曲线，评价APRI、FIB-4、CⅣ、LN诊断乙型肝炎肝硬化的价值，选择当敏感性及特异性之和最大为诊断阈值及≥95%特异性为诊断阈值时，上述各指标诊断乙型肝炎肝硬化的价值。结果 慢性乙型肝炎组年龄、FIB-4、APRI、CⅣ、LN水平低于乙型肝炎肝硬化组，PLT、ALT高于乙型肝炎肝硬化组，差异均有统计学意义（P＜0.05）；相关性分析显示，年龄、CⅣ、LN、FIB-4、APRI与乙型肝炎肝硬化呈正相关，ALT、PLT与乙型肝炎肝硬化呈负相关，AST与乙型肝炎肝硬化无相关性；ROC曲线显示，APRI、FIB-4、CⅣ、LN均对乙型肝炎肝硬化有一定的诊断价值；选定敏感性及特异性之和最大为诊断乙型肝炎肝硬化的阈值，FIB-4、APRI、CⅣ、LN的阈值分别为3.14、1.01、86.45 ng/ml、59.48 ng/ml；选定特异度≥95%为诊断乙型肝炎肝硬化的阈值，FIB-4、APRI、CⅣ、LN的阈值分别为3.72、2.55、473.35 ng/ml、270.09 ng/ml。结论 APRI、FIB-4、CⅣ、LN均对乙型肝炎肝硬化有一定的诊断价值，当选定敏感性及特异性之和最大诊断乙型肝炎肝硬化时，可减少漏诊；当选取特异度≥95%诊断乙型肝炎肝硬化时，可以减少误诊。
Abstract:
Objective To analyze the fibrosis index (FIB-4), aspartate aminotransferase/platelet ratio (APRI), serum type IV collagen (CIV), laminin (LN) and hepatitis B cirrhosis based on 4 factors relationship and observe its diagnostic value for hepatitis B liver cirrhosis.Methods Collecting from October 2018 to June 2020 in the Department of Gastroenterology and Infectious Diseases, Liuzhou People’s Hospital, Guangxi Medical University,260 patients with chronic hepatitis B and hepatitis B liver cirrhosis admitted to the Department of Gastroenterology, Affiliated Hospital of Guilin Medical University were the research objects.Among them, 128 patients with chronic hepatitis B were regarded as the chronic hepatitis B group, and 132 patients with hepatitis B cirrhosis were regarded as the hepatitis B cirrhosis group. The age, aspartate aminotransferase (ALT), alanine aminotransferase (AST), and platelets were compared between the two groups. (PLT), FIB-4, APRI, CIV and LN levels,analyze the relationship between the above indicators and the occurrence of cirrhosis, draw the ROC curve, and evaluate the value of APRI, FIB-4, CIV, LN in the diagnosis of hepatitis B cirrhosis,when the maximum sum of sensitivity and specificity was the diagnostic threshold and ≥95% specificity was the diagnostic threshold, the value of the above indicators in the diagnosis of hepatitis B cirrhosis was selected.Results The age, FIB-4, APRI, CIV, and LN levels in the chronic hepatitis B group were lower than those in the hepatitis B cirrhosis group, and PLT and ALT were higher than those in the hepatitis B cirrhosis group,the differences were statistically significant (P<0.05)；Correlation analysis showed that age, CIV, LN, FIB-4, APRI were positively correlated with hepatitis B cirrhosis, ALT, PLT were negatively correlated with hepatitis B cirrhosis, and AST had no correlation with hepatitis B cirrhosis;The ROC curve shows that APRI, FIB-4, CIV, and LN all had a certain diagnostic value for hepatitis B cirrhosis; the maximum selected sensitivity and specificity was the threshold for the diagnosis of hepatitis B cirrhosis.The thresholds of FIB-4, APRI, CIV, and LN are 3.14, 1.01, 86.45 ng/ml, 59.48 ng/ml, respectively;The selected specificity ≥ 95% was the threshold for diagnosing hepatitis B cirrhosis, and the thresholds for FIB-4, APRI, CIV, and LN were 3.72, 2.55, 473.35 ng/ml, and 270.09 ng/ml, respectively.Conclusion APRI, FIB-4, CIV, and LN all have certain diagnostic value for hepatitis B cirrhosis. When the maximum sensitivity and specificity are selected to diagnose hepatitis B cirrhosis, missed diagnosis can be reduced; when specificity is selected ≥95% of the diagnosis of hepatitis B cirrhosis can reduce misdiagnosis.

参考文献/References:

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更新日期/Last Update: 1900-01-01