APRI、 FIB-4对乙肝纤维化的诊断价值

Diagnostic Value of APRI and FIB—4 for Hepatitis B Fibrosis

目的探讨天门冬氨酸氨基转移酶和血小板比率指数(Aspartate Aminotransferase-toplatelet Ratio Index,APRI)、基于4因子的纤维化指数(Fibrosis Index Based On The Four Factors,FIB-4)对乙肝纤维化的诊断价值。方法回顾收集我院确诊的220例乙肝患者临床资料。定性资料以频率(%)表示,以卡方检验进行比较。定量资料若满足正态性以均数±标准差表示,以方差分析进行比较;若不满足正态性以中位数(四分位数间距)表示,以非参数秩和检验进行比较。采用ROC曲线分析APRI、FIB-4对乙肝纤维化的诊断价值。结果 APRI、FIB-4在不同的乙肝纤维化分期具有统计学差异(P<0.05)。APRI诊断S1-4组、S2-4组和S4组的的曲线下面积(AUC)分别为0.661(0.598~0.724)、0.668(0.606~0.730)、0.693(0.631~0.754),FIB-4诊断的AUC分别为0.695 (0.634~0.756)、0.697 (0.636~0.758)、0.733 (0.674~0.792),均略高于APRI。结论 APRI、FIB-4对于乙肝纤维化的诊断价值较高,其中FIB-4为首选指标。

Objective To explore the value of aspartate aminotransferase-to-platelet ratio index(APRI), fibrosis index based on the four factors(FIB-4) in diagnosis of hepatitis B fibrosis. Methods The clinical data of 220 hepatitis B patients diagnosed in our hospital were retrospectively collected. Qualitative data is expressed in terms of frequency(%) and compared by chi-square test. If quantitative data satisfies the normality, it is expressed as mean±standard deviation, and compared by analysis of variance;if the normality is not satisfied, it is expressed as median(interquartile range), and compared by nonparametric rank sum test. The ROC curve was used to analyze the diagnostic value of APRI and FIB-4 for hepatitis B fibrosis. Results APRI and FIB-4 were statistically different in different stages of hepatitis B fibrosis(P<0.05). The AUC of APRI for the diagnosis of S1-4, S2-4 and S4 group in APRI were 0.661(0.598-0.724), 0.668(0.606-0.730), 0.693(0.631-0.754) respectively;the AUC of FIB-4 for diagnosis were 0.695(0.634-0.756), 0.697(0.636-0.758), 0.733(0.674-0.792) respectively, slightly higher than that of APRI. Conclusion APRI and FIB-4 have high diagnostic value for hepatitis B fibrosis. FIB-4 is the first choice.