FIB-4指数对ALT小于2倍正常值上限的慢性HBV感染患者肝纤维化的诊断价值

发布时间：2018-03-07 02:30

本文选题：FIB-指数　切入点：肝纤维化　出处：《安徽医科大学学报》2015年06期 　论文类型：期刊论文

【摘要】：目的探讨FIB-4指数对谷丙转氨酶(ALT)小于2倍正常值上限的慢性乙型肝炎病毒(HBV)感染患者肝纤维化程度的诊断价值。方法对416例ALT小于2倍正常值上限的慢性HBV感染患者进行肝脏穿刺病理检查,同时检测肝穿当天患者的ALT、谷草转氨酶(AST)、血小板等指标。根据FIB-4计算公式得出FIB-4指数值,以肝穿病理结果为金标准绘制FIB-4指数的受试者工作特征曲线(ROC),计算曲线下面积,评价FIB-4指数对显著肝纤维化、严重肝纤维化和肝硬化的预测价值。结果随着肝纤维化程度的加重,FIB-4指数逐步升高,在S1~S4 4组间差异有统计学意义(P0.05)。E抗原阳性与阴性患者的FIB-4指数比较差异有统计学意义(P0.05)。E抗原阳性患者诊断显著肝纤维化、严重肝纤维化、肝硬化的FIB-4指数截断值分别为1.283、1.283和1.449,分别对应不同的灵敏度和特异度。而在E抗原阴性的患者中,其相应的截断值为2.094、2.094和2.415。结论 FIB-4指数对于ALT小于2倍正常值上限的慢性HBV感染患者是一种简单、有效的无创肝纤维化评价指标,可使大部分患者避免肝穿活检。
[Abstract]:Objective to investigate the diagnostic value of FIB-4 index for hepatic fibrosis in patients with chronic hepatitis B virus (HBV) infection whose alt is less than 2 times the upper limit of normal value. Methods 416 cases of chronic HBV infection with ALT less than 2 times the upper limit of normal value were studied. The patient underwent liver biopsy and pathological examination. At the same time, the alt, alt, AST, platelet and so on were detected. According to the FIB-4 formula, the FIB-4 index was obtained. The operating characteristic curve of FIB-4 index was drawn according to the pathological results of liver puncture as gold standard, and the area under the curve was calculated. To evaluate the predictive value of FIB-4 index for significant hepatic fibrosis, severe hepatic fibrosis and liver cirrhosis. Results the FIB-4 index increased gradually with the severity of hepatic fibrosis. There was significant difference in FIB-4 index between S1-S44 group and P0.05Ag-positive group. There was significant difference in FIB-4 index between P0.05Ag-E antigen positive group and S1-S44 group. There was a significant difference in the diagnosis of liver fibrosis and severe hepatic fibrosis in patients with positive P0.05-E antigen. The truncation values of FIB-4 index in cirrhosis were 1.283 and 1.449, respectively, corresponding to different sensitivity and specificity. The corresponding truncation values were 2.094n2.094 and 2.415.Conclusion FIB-4 index is a simple and effective non-invasive index for evaluating liver fibrosis in patients with chronic HBV infection whose ALT is less than 2 times the upper limit of normal value, and can make most patients avoid liver biopsy.
【作者单位】：安徽医科大学第二附属医院肝病科;
【基金】：安徽高校省级自然科学基金(编号:KJ2014A107)
【分类号】：R512.62

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