PDF下载 ( 170 KB)
The diagnostic value of APRI and Forns index for liver fibrosis of chronic hepatitis B
-
摘要: 目的验证APRI和Forns指数对诊断慢乙肝肝纤维化的临床价值。方法172例慢性乙肝患者均接受肝组织病理检查,并同时检测肝功能、血常规和血脂,用ROC曲线评价APRI和Forns指数诊断慢乙肝肝纤维化的能力。结果肝纤维化分期与APRI/Forns指数的相关系数分别是0.312和0.315（P<0.01）;肝纤维化S4的APRI和Forns指数均高于S0/S1/S2/S3（P<0.05）;ROC曲线分析显示APRI和Forns指数诊断显著肝纤维化（S2-S4）的AUC均小于0.7,诊断S4的AUC均大于0.7;APRI诊断S4的敏感性（SN）80、特异性（SP）74、阳性预测值（PPV）34.5和阴性预测值（NPV）95.6;Forns指数诊断S4的SN92、SP63、PPV29.9和NPV97.9。结论APRI和Forns指数与肝纤维化分期均有一定的相关性,可以用于肝纤维化S4的诊断,但对肝纤维化S1、S2和S3的区分能力有限。Abstract: Objective To testify the clinical value of APRI and Forns index diagnosis liver fibrosis of chronic hepatitis B.Methods There were 172 patients with chronic hepatitis B who were underwent liver biopsy with their liver function, blood routine and blood fat taken simultaneously.Three different endpoints were studied according to liver fibrosis stage, namely without/light fibrosis (S0/S1) , significant fibrosis (S2/S3/S4) and cirrhosis (S4) .The area under the ROC curves (AUC) reflected its diagnostic values.Results The correlation coefficient between liver fibrosis stage and APRI/Forns index was 0.312 and 0.315, respectively (P<0.01) .The APRI and Forns index of fibrosis S4 were higher than those of S0, S1, S2 and S3 (P<0.05) .The AUC for significant fibrosis of APRI/Forns index was low to 0.7 while that for cirrhosis was high to 0.7.The sensitivity (SN) , specificity (SP) , positive predictive value (PPV) and negative predictive value (NPV) of APRI evaluating cirrhosis (S4) were 80%, 74%, 34.5% and 95.6%, respectively, while those of Forns index were 92%, 63%, 29.9% and 97.9%, respectively.Conclusion There is correlation between liver fibrosis stage and APRI/Forns index.APRI/Forns index can valuate fibrosis S4 in patients with chronic hepatitis B, however, it can not discriminate fibrosis S1, S2 and S3.
-
2023年8月25日，中华医学会关于“2023年度中华医学科技论文TOP100”遴选结果的公示结束。继2022年首次参评并入选1篇文章之后，《临床肝胆病杂志》2023年度2篇推选文章——2020年36卷第2期《慢性乙型肝炎患者肝脏硬度值下降趋势与肝纤维化逆转结局的关系》、2021年37卷第7期《基于瞬时弹性成像技术检测参数的非酒精性脂肪性肝病进展评估模型的建立》，再度荣膺“中华医学科技论文TOP100”。
中国科协优秀科技论文遴选工作由中国科学技术协会组织，自2016年始，每年举办一届，2023年为第八届。为鼓励科技工作者切实加强基础研究和关键核心技术攻关，将更多高水平研究成果在国内期刊发表，从源头推动我国科技期刊高质量发展而举办。遴选工作分10个学科集群进行，每个学科集群由1家全国学会牵头负责集群内论文遴选工作。中华医学会每年承担中国科协优秀科技论文遴选（临床医学集群）牵头工作，同时面向全国医药卫生领域期刊开展当年度“中华医学科技论文TOP100”评选活动。2023年度TOP100入选论文将通过专家现场评审，从中遴选22篇（包括10篇临床研究型、10篇基础研究型、2篇综述型）作为入选第八届中国科协优秀科技论文（临床医学集群）的候选论文推荐至中国科协。 更多详情请见：http://top100.medline.org.cn/。
《临床肝胆病杂志》编辑部 2023年9月20日 -
[1]赵连荣, 许德军, 陆忠华, 等.综合预测模型FibroTest对慢性乙型肝炎肝纤维化的诊断价值[J].中国实用内科杂志, 2007, 27 (16) :1274-1277. [2]Beom K K, Sung A K, Young N P, et al.Noninvasive models to predict liver cirrhosis in patients with chronic hepatitis B[J].Liver International, 2007, 27 (7) :969-976. [3]Carlo F, Carlo, Pierluigi T, et al.Assessment of liver fibrosis pro-gression in patients with chronic hepatitis C and normal alanine amin-otransferase values:The role of AST to the platelet ratio index[J].Clinical Biochemistry, 2006, 39 (4) :339-343. [4]Ralf L, Matthias J B.Noninvasive diagnosis of fibrosis in chronic liv-er disease[J].Expert Rev Mol Diagn, 2004, 4 (5) :715-726. [5]Thabut D, Simon M, Myers RP, et al.Noninvasive prediction of fi-brosis in patients with chronic hepatitis C[J].Hepatology, 2003, 37 (5) :1220-1221. [6] 中华医学会.病毒性肝炎防治方案[J].中华肝脏病杂志, 2000, 8 (6) :324-329. [7]朱肖鸿, 叶蕾.非创伤性指标评判安珐特治疗肝纤维化的疗效[J].临床肝胆病杂志, 2005, 21 (5) :301-302. [8]夏琦, 符节海, 蔡卫民, 等.AST/PLT和GGT/PLT比值对肝纤维化的诊断价值[J].临床肝胆病杂志, 2007, 23 (5) :364-366. [9]Philippe H, Francoise I B, Djamila M, et al.A prospective assess-ment of the inter-laboratory variability of biochemical markers of fi-brosis (FibroTest) and activity (ActiTest) in patients with chronic liver disease[J].Comparative Hepatology, 2002, 1 (3) :1-10. [10]Leonardo L S, Janana L N S, Roberto J C F, et al.Simple Blood Tests as Noninvasive Markers of Liver Fibrosis in Hemodialysis Pa-tients with Chronic Hepatitis C Virus Infection[J].Hepatology, 2007, 46 (2) :307-314. -
下载:
