慢性乙型肝炎患者天门冬氨酸氨基转移酶/血小板指数在肝纤维化分级中的临床意义

Clinical significance of aspartate aminotransferase to platelet ratio index for predicting liver fibrosis in chronic hepatitis B

目的探讨慢性乙型肝炎(CHB)患者天门冬氨酸氨基转移酶(AST)/血小板(PLT)指数(APRI)在预测肝纤维化中的应用价值。方法选取156例CHB患者作为研究对象,评估不同肝纤维化分期与APRI的关系,分析APRI预测显著肝纤维化和重度肝纤维化的准确率,并对28例CHB患者抗病毒治疗前后肝组织纤维化分期和APRI的变化进行比较。结果 APRI随着肝纤维化程度的增高而升高,其预测CHB患者发生显著肝纤维化及重度肝纤维化的曲线下面积分别为0.786和0.703,与无或轻度肝纤维化比较,差异有统计学意义(P<0.01)。APRI>1.5时,其阳性预测值为97%;APRI>2.0时,其阳性预测值为76%。28例CHB患者经抗病毒药物治疗后,其纤维化程度及APRI显著低于治疗前,差异有统计学意义(P<0.01)。结论 APRI可作为预测CHB患者肝纤维化及重度肝纤维化的指标之一。

Objective To explore the application effect of aspartate aminotransferase to platelet ratio index （APRI） for predicting liver fibrosis in chronic hepatitis B （CHB）. Methods 156 cases with CHB were selected as the research ob-ject. The correlation of liver fibrosis and APRI was evaluated,the accuracy rate of APRI for predicting significant fibro-sis and cirrhosis was analyzed,stage of fibrosis and APRI before and after antiviral treatment were analyzed in 28 CHB patients. Results APRI was increased with increasing the degree of liver fibrosis,the predicted area of significant fibro-sis and severe liver fibrosis curves of APRI was 0.786 and 0.703 reapectively,compared with no or mild fibrosiscom-pared,there was statistically significant（P〈0.01）.When APRI was greater than 1.5,the positive predictive value was 97%. When APRI was greater than 2.0,the positive predictive value was 76%.28 CHB patients with antiviral therapy,the de-gree of fibrosis and APRI after treatment was significantly lower than before treatment,with significant difference （P〈0.01）. Conclusion APRI can be used as one of the prediction index of liver fibrosis with CHB and severe liver fibrosis.