APRI和Forns指数对慢乙肝肝纤维化的诊断价值

蒋忠胜; 温小凤; 柯柳; 覃川; 陈念; 李敏基

APRI和Forns指数对慢乙肝肝纤维化的诊断价值

基金项目:

广西卫生厅自筹经费计划课题(Z2008398)；

详细信息

中图分类号: R575.2;R512.62
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出版历程
- 出版日期: 2008-06-20

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

Research funding:

摘要

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。
- 慢性乙型病毒性肝炎 /
- 肝纤维化 /
- 受试者工作特性曲线
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.
- chronic hepatitis B /
- liver fibrosis /
- the receiver operating characteristic curve (ROC)

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参考文献(10)

[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.

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