血清HBeAg阴性慢性乙型肝炎患者APRI、FIB-4和血清TGF-β1水平变化

Changes of APRI and FIB-4 scores in patients with serum HBeAg-negative chronic hepatitis B

目的调查血清HBeAg阴性的慢性乙型肝炎(CHB)患者天门冬氨酸氨基转移酶与血小板比值(APRI)、基于4因子指数(FIB-4)和血清转化生长因子-β1(TGF-β1)的变化。方法2018年1月~2019年5月我院诊治的血清HBeAg阴性的CHB患者78例和同期健康人78例,采用ELISA法测定血清TGF-β1水平,常规检测血生化指标,计算APRI和FIB-4评分。CHB患者接受肝活检,并行肝纤维化分期。结果CHB患者APRI评分为(0.9±0.4),显著高于健康人[(0.3±0.1),P<0.05];FIB-4评分为(1.4±0.4),显著高于健康人[(0.5±0.2),P<0.05],血清TGF-β1水平为(14.5±5.3)ng/ml,显著高于健康人[(7.4±3.5)ng/ml,P<0.05];33例CHB患者肝组织F0~1者APRI评分为(0.5±0.2),显著低于24例肝组织F2者[(1.0±0.3),P<0.05],显著低于12例肝组织F3者[(1.3±0.5),P<0.05],也显著低于9例肝组织F4者[(1.8±1.6),P<0.05];F0~1患者FIB-4评分为(0.9±0.3),显著低于F2患者[(1.5±0.4),P<0.05],显著低于F3患者[(1.9±0.4),P<0.05],也显著低于F4患者[(3.2±0.6),P<0.05];F0~1患者血清TGF-β1水平为(9.7±3.6)ng/ml,显著低于F2患者[(10.5±4.4)ng/ml,P<0.05],显著低于F3患者[(15.8±5.9)ng/ml,P<0.05],也显著低于F4患者[(19.5±6.2)ng/ml,P<0.05]。结论血清HBeAg阴性的CHB患者APRI、FIB-4和血清TGF-β1水平发生了显著的变化,随着肝纤维化程度的加重,这些指标变化更明显,可能有助于提高对肝纤维化的诊断。

Objective The aim of this study was to investigate the changes of ratio of aspartate aminotransferase to platelet counts(APRI),based on fibrosis-four(FIB-4)and serum transforming growth factor-β1(TGF-β1)in patients with serum HBeAg negative chronic hepatitis B(CHB).Methods 78 patients with serum HBeAg-negative CHB and 78 healthy persons were enrolled in our hospital from January 2018 through May 2019,and the APRI,FIB-4 and serum TGF-β1 levels were detected or calculated.The liver biopsies were performed in all patients with CHB.Results The APRI score in patients with CHB was(0.9±0.4),which was significantly higher than that in the healthy group[(0.3±0.1),P<0.05],the FIB-4 score was(1.4±0.4),significantly higher than[(0.5±0.2),P<0.05]in the healthy persons,and serum TGF-β1 level in patients with CHB was(14.5±5.3)ng/ml,which was significantly higher than[(7.4±3.5),P<0.05]ng/ml in healthy persons;the APRI score in 33 patients with hepatic F0-1 fibrosis was(0.5±0.2),significantly lower than[(1.0±0.3),P<0.05]in 24 patients with F2,significantly lower than[1.3.±0.5),P<0.05]in 12 patients with F3,and also significantly lower than[(1.8±1.6),P<0.05]in 9 patients with F4;the FIB-4 score in patients with F0-1 was(0.9±0.3),significantly lower than[(1.5±0.4),P<0.05]in patients with F2,significantly lower than[(1.9±0.4),P<0.05]in patients with F3,and also significantly lower than[(3.2±0.6),P<0.05]in patients with F4;the serum TGF-β1 level in patients with F0-1 was(9.7±3.6)ng/ml,which was significantly lower[(10.5±4.4)ng/ml,P<0.05]in patients with F2,significantly lower than[(15.8±5.9)ng/ml,P<0.05]in patients with F3,and also significantly lower than[(19.5±6.2)ng/ml,P<0.05]in patients with F4.Conclusion The APRI and FIB-4 scores as well as serum TGF-β1 levels in serum HBeAg-negative patients with CHB increase greatly,which might help improve the diagnostic accuracy of liver fibrosis in this setting.