比较FIB-4和APRI在中国HBV感染的患者ALT持续正常, 轻度ALT升高

StephenW

比较FIB-4和APRI在中国HBV感染的患者
ALT持续正常,
轻度ALT升高




Comparison of FIB-4 and APRI in Chinese HBV-infected patients with
persistently normal ALT and mildly elevated ALT

H. Wang1,*,
L. Xue2,
R. Yan1,
Y. Zhou1,
M. S. Wang1,
M. J. Cheng1,
H. J. Huang1
Article first published online: 19 NOV 2012
DOI: 10.1111/jvh.12010
© 2012 Blackwell Publishing Ltd

Issue

Journal of Viral Hepatitis

Summary

Significant liver disease has been reported in chronic hepatitis B patients
with normal alanine aminotransferase (ALT). Liver biopsy (LB) is the
current gold standard for assessing hepatic inflammation and fibrosis in
patients with chronic HBV. However, associated risks have led to the
development of noninvasive models. Their utility in patients with normal
ALT is unknown. FIB-4 and aspartate aminotransferase (AST)-to-platelet
ratio index (APRI) were calculated for patients with chronic HBV infection
undergoing biopsy. The performance of each model and AUROC for predicting
significant fibrosis (Scheuer's score ≥ S2) were determined for the
entire cohort and stratified by elevated (≥50 U/L) and normal ALT.
Two-hundred and thirty-one liver biopsies were included. The number of
patient with normal ALT was 140, and 22.1% had significant fibrosis. The
AUROC curve for patients with normal ALT was 0.81 for FIB-4 and 0.80 for
APRI, compared with 0.71 for FIB-4 and 0.72 for APRI for those with mildly
elevated ALT level. The sensitivity, specificity, positive predictive value
(PPV) and negative predictive value (NPV) of FIB-4 were 0.63, 0.88, 0.61
and 0.93, for patients with normal ALT; the values for APRI were 0.40,
0.88, 0.33 and 0.93. Both FIB-4 and APRI are useful for identification of
those without significant fibrosis. However, because they have poor PPV, LB
will continue to be used for assessment of HBV-infected patients with
normal ALT and mildly elevated ALT.

StephenW

在中国HBV感染的患者比较FIB-4和APRI
ALT持续正常，轻度ALT升高

H. Wang1，*，
L. Xue2，
R.艳1，
Y. Zhou1，
M. S.王，
M. J.成1，
H. J. Huang1
在网上公布：2012年11月19日
DOI：10.1111/jvh.12010
©2012 Blackwell出版有限公司

问题

中国病毒性肝炎

总结

据报道，在慢性乙型肝炎患者显着的肝脏疾病
与正常的谷丙转氨酶（ALT）。肝活检（LB）是
目前的黄金标准评估肝脏炎症和纤维化
慢性乙肝患者。然而，相关的风险已导致
发展非侵入性的模型。正常的患者，他们的效用
ALT是未知的。 FIB-4和天门冬氨酸氨基转移酶（AST），血小板
慢性HBV感染患者分别计算比值指数（APRI）
进行活检。每个模型的性能和AUROC预测
被确定为显着性纤维化（朔伊尔的得分≥S2）
整个队列和分层的升高（≥50 U / L）和ALT正常。
两百年和31例肝活检。的数目
ALT水平正常的患者为140，22.1％有显着性纤维化。 “
AUROC曲线ALT正常的患者FIB-4和0.800.81
APRI，FIB-4和0.720.71 APRI为轻度
ALT水平升高。的敏感性，特异性，阳性预测值
（PPV）和阴性预测值（NPV）FIB-4分别为0.63，0.88，0.61
和0.93，ALT正常的患者，为APRI值分别为0.40，
0.88，0.33和0.93。这两个FIB-4和APRI是有用的用于识别
没有显著纤维化。然而，因为他们有可怜的PPV，LB
将继续被HBV感染的病人的评估与用于
正常的ALT和ALT轻度升高。