GPR指数在ALT≤2×ULN慢性乙型肝炎患者肝组织学无创评估中的临床应用

目的评价GPR指数评估ALT≤2×ULN（正常上限）慢性乙型肝炎（CHB）患者肝组织病理炎症坏死分级、纤维化分期的价值。方法回顾性分析153例AL17≤2×ULN的CHB患者肝脏活组织病理检查和血清γ-GT、ALT、PLT检测结果，计算出GPR，应用受试者工作特征（ROC）曲线评价GPR指数对炎症坏死分级（G）、纤维化分期（S）的诊断价值。结果炎症分级≥G2组患者比〈G2组的γ-GT、ALT升高，PLT降低，差异有统计学意义（P〈0．05）；纤维化分期≥S2组患者比〈S2组的γ-GT、ALT升高，PLT降低，差异有统计学意义（P〈0．05）。GPR预测S2、G2及以上肝组织学改变的ROC曲线下面积分别为0．730、0．704。结论GPR对无创评估ALT≤2×ULN的CHB患者的活动性肝病有一定帮助。

Objective To evaluate the performance of gamma-glutamyltranspeptidase to platelet ratio （ GPR ） index in the assessment of liver histopathological inflammatory grade （ G ） and fibrosis stage （ S ） in chronic hepatitis B virus （ HBV ） infection patients with alanine aminotransferase （ ALT ） ≤2× upper limits of normal （ ULN ） . Methods 153 patients clinically diagnosed chronic HBV infection with ALT≤2× ULN were analyzed retrospectively.Liver tissue and gamma-glutamyltranspeptidase （ γ -GT ） , ALT, platelet （ PLT ） were performed and calculated the ratio of γ-GT to PLT, namely the GPR, and were assessed diagnostic value of GPR index in inflammatory grade and fibrosis stage by using receiver operating characteristic （ ROC ） curves. Results Inflammatory grade ≥ G2 group compared with the〈G2 group, γ-GT and ALT increased, PLT decreased and showed significant difference. （ P〈0.05 ） .The same results were in fibrosis stage≥ S2 group and the〈S2 group （ P〈0.05 ） . The area under the ROC curve of GPR predicting the fibrosis stage≥S2 and Inflammatory grade 1〉 G2 were 0.730 and 0.704 respectively.