GP73、APRI、FIB-4在慢性HBV感染肝纤维化中的诊断价值

Diagnostic value of GP73,APRI and FIB-4 in chronic HBV infection with hepatic fibrosis

目的探讨高尔基体蛋白73(GP73)、天门冬氨酸氨基转移酶/血小板比值指数(APRI)、基于4因子的纤维化指数(FIB-4)在慢性HBV感染肝纤维化中的诊断价值。方法选取2015年7月至2017年6月间本院收治的125例慢性HBV感染患者作为研究对象,根据Scheuer系统标准分为显著肝纤维化组62例(S2～S4)和轻度肝纤维化组63例(S0～S1)。比较两组GP73、APRI、FIB-4水平及其与肝纤维化的相关性,并分析三者对肝纤维化的诊断价值。结果显著肝纤维化组的GP73、APRI、FIB-4水平均高于轻度肝纤维化组(P均为0.000)。GP73、APRI、FIB-4模型与肝纤维化的相关性均较好(r值分别为0.530、0.502、0.610,P值分别为:0.003、0.002、0.000),且FIB-4与肝纤维化的相关性最大(r=0.610,P=0.000)。FIB-4模型的诊断价值优于APRI模型,两者曲线下面积(AUC)存在差异(Z=2.325,P=0.019)。结论 GP73、APRI、FIB-4模型对肝纤维化均有较好的诊断价值,其中以FIB-4模型诊断价值最优。

Objective To investigate the diagnostic value of Golgi protein 73（GP73）,aspartate aminotransferase/plateletratio index（APRI）and fibrosis index based on the 4 factor（FIB-4）in the diagnosis of hepatic fibrosis in chronic HBVinfection. Methods A total of 125 patients with chronic HBV infection admitted to our hospital from July 2015 to June2017 were selected and divided into two groups according to Scheuer criteria：liver fibrosis（S2～S4）group（62 cases）andmild liver fibrosis（S0～S1）group（63 cases）. The correlation of GP73,APRI and FIB-4 with liver fribosis were analyzed.Results The values of GP73,APRI and FIB-4 in patients with significant hepatic fibrosis were significantly higher thanthose in patients with mild hepatic fibrosis（P=0.000）. GP73,APRI,FIB-4 model and liver fibrosis were good（r valueswere 0.530,0.502,0.610,P values were 0.003,0.002,0.000）,and FIB-4 and liver fibrosis correlation was maximum（r=0.610,P=0.000）. The diagnostic value of FIB-4 was better than that of APRI,and there was a difference in area under curve（AUC）values（Z=2.325,P=0.019）. Conclusion The GP73,APRI and FIB-4 models have good diagnostic value forliver fibrosis,and the best value was the FIB-4 model.