The diagnostic value of APRI and Forns index for liver fibrosis of chronic hepatitis B
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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.
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