血清肝纤维化指标在临床中的应用评价

The value of clinical application of serum hepatic fibrosis indices

目的:运用受试者工作特征(ROC)曲线评价肝纤维化指标在慢性肝病中的应用价值。方法:对145例肝病患者血清肝纤维化指标进行检测并采用ROC曲线评价其诊断效率。结果:慢性肝炎与急性肝炎鉴别的单项指标HA、PCⅢ、LN、Ⅳ.C的灵敏度和特异度分别为:46%～56%和72%～86%,ROC曲线下面积(AUC)为0.621～0.730;而肝硬化与慢性肝炎鉴别的单项指标灵敏度和特异度分别为:50%～71%和79%～91%;ROC曲线下面积(AUC)为0.633～0.874;6种联合模式平行试验的灵敏度为84.4%～97.2%,特异度为55.6%～81.9%;其中,4项联合指标的阴性似然比为0.05;而第6种联合模式序列试验的灵敏度为13.4%～45.5%,特异度为97.7%～99.9%,阳性似然比均>10。结论:4项联合指标的平行试验可作为排除肝硬化的诊断试验,第6种联合模式序列试验可作为判断肝硬化的较好指标。

Objective： To evaluate the application value of hepatic fibrosis indices in the chronic liver disease with ROC curve analysis.Methods：Hepatic fibrosis indices in 145 patients with liver diseases were detected,and the diagnostic efficiency was evaluated with ROC curve.Results：The sensitivity and specificity of differential event index of HA,PCⅢ,LN and Ⅳ.C in acute hepatitis and chronic hepatitis were 46%~56% and 72%~86%,AUC-ROC was 0.621-0.730;and that of liver cirrhosis and chronic hepatitis were 50%～71% and 79%～91%,AUC-ROC was 0.633-0.874.The sensitivity of six federated models parallel test were 84.4%～97.2%,and the specificity were 55.6%～81.9%,and the negative likelihood ratio of four indices was 0.05;and the sensitivity and specificity of six federated models array test were 13.4%～45.5% and 97.7%～99.9%,and the positive likelihood ratio was 10.Conclusion： The parallel test of four indices can be the diagnostic test to differentiate the live cirrhosis,and the sixth federated models array test can be more useful indicators to judge liver cirrhosis.