AST / ALT比例没有在预测纤维化的程度在慢性病毒性肝炎的患

StephenW

    European Journal of Gastroenterology & Hepatology:   
    December 2015 - Volume 27 - Issue 12 - p 1361–1366
            doi: 10.1097/MEG.0000000000000468
    Original Articles: Hepatitis
  
  AST/ALT ratio is not useful in predicting the degree of fibrosis in chronic viral hepatitis patients      

Eminler, Ahmet Tarika; Ayyildiz, Talatb; Irak, Kaderc; Kiyici, Muratc; Gurel, Selimc; Dolar, Enverc; Gulten, Macitc; Nak, Selim G.c

              
   
   
  
      [url=][/url]Abstract      
   
         

Background and aim: Noninvasive tests are primarily used for staging hepatic fibrosis in patients with chronic liver disease. In clinical practice, serum aminotransferase levels, coagulation parameters, and platelet count have been used to predict whether or not a patient has cirrhosis. In addition, several studies have evaluated the accuracy of combinations (or ratios) of these measures. The present study aimed to investigate the relationship between five noninvasive models [AST/ALT ratio (AAR), aspartate aminotransferase to platelet ratio index (APRI), Bonacini cirrhosis discriminant score (CDS), age–platelet index (APind), and King’s score] and the degree of hepatic fibrosis as determined by biopsy in patients with chronic hepatitis B and C.

      

Patients and methods: A total of 380 patients with viral hepatitis (237 with chronic hepatitis B and 143 with chronic hepatitis C) who were seen at our clinic between January 2005 and January 2011 were retrospectively analyzed. The degree of fibrosis was determined using the Ishak score. Patients with a fibrosis score of 0–2 were considered to have low fibrosis and those with a score between 3 and 6 were considered to have high fibrosis. Five noninvasive models were compared between the groups with low and high fibrosis.

      

Results: There were statistically significant differences between the hepatitis B and C patients with high and low fibrosis with respect to APind (4.49±2.35 vs. 2.41±1.84; P<0.001 in hepatitis B and 4.83±2.25 vs. 2.92±1.88; P<0.001 in hepatitis C), APRI (1.00±1.17 vs. 0.47±0.39; P<0.001 in hepatitis B and 1.01±1.01 vs. 0.41±0.29; P<0.001 in hepatitis C), CDS (4.53±1.90 vs. 3.58±1.30; P<0.001 in hepatitis B and 4.71±2.03 vs. 3.42±1.49; P<0.05 in hepatitis C), and King’s score (24.31±3.14 vs. 7.65±6.70; P<0.001 in hepatitis B and 24.82±2.55 vs. 8.33±7.29; P<0.001 in hepatitis C). There were no significant differences in the AAR between the hepatitis B and C patients with high and low fibrosis (0.78±0.31 vs. 0.74±0.34; P=0.082 in hepatitis B and 0.91±0.40 vs. 0.85±0.27; P=0.25 in hepatitis C). The area under the receiver-operating characteristic curve of the APind, APRI, CDS, and King’s score in the hepatitis B group were 0.767, 0.710, 0.646, and 0.770, respectively; these values were 0.732, 0.763, 0.677, and 0.783, respectively, in the hepatitis C group.

      

Conclusion: In conclusion, our data suggest that four of the five noninvasive methods evaluated in this study can be used to predict advanced fibrosis in patients with hepatitis B and C. However, there was no significant relationship between the degree of hepatic fibrosis and the AAR score, indicating that AAR is not useful in estimating the fibrosis stage in hepatitis B and C patients.

   
  

StephenW

欧洲胃肠病学和肝病学：
2015年12月 - 27卷 - 12期 - P 1361-1366
DOI：10.1097 / MEG.0000000000000468
原创文章：肝炎
AST / ALT比例没有在预测纤维化的程度在慢性病毒性肝炎的患者有用

Eminler，艾哈迈德Tarika; Ayyildiz，Talatb; IRAK，Kaderc; Kiyici，Muratc;居雷尔，Selimc;豆捞，Enverc;面筋，Macitc; NAK，塞利姆G.c
折叠盒
抽象的

背景与目的：非侵入性的测试主要用于分期肝纤维化患者的慢性肝病。在临床实践中，血清转氨酶水平，凝血参数，和血小板计数已被用于预测患者是否具有肝硬化。此外，一些研究已经评价了这些措施的组合（或比率）的准确性。本研究旨在探讨5无创模型[AST / ALT比值（AAR），谷草转氨酶与血小板比例指数（APRI），Bonacini肝硬化判别分数（CDS），年龄血小板指数（APind）和国王的得分之间的关​​系]和肝纤维化的程度通过活检慢性乙型和丙型肝炎确定

患者和方法：总共有380例病毒性肝炎患者（237慢性乙型肝炎患者和143名患有慢性丙型肝炎）谁是看到在我们2005年1月和2011年1月间诊所进行回顾性分析。纤维化的程度是使用伊沙克评分来确定。例0-2一个纤维化评分被认为具有低的纤维化和那些具有3至6分被认为具有高的纤维化。五个无创模式组具有低和高纤维化之间进行了比较。

结果：有相对的乙型和丙型肝炎患者的高和低纤维化的统计显著差异APind（4.49±2.35与2.41±1.84; P <0.001乙肝和4.83±2.25与2.92±1.88，P丙型肝炎<0.001），APRI（1.00±1.17对0.47±0.39; P <0.001乙型肝炎和1.01±1.01对0.41±0.29; P <丙肝0.001），CDS（4.53±1.90对比3.58 ±1.30; P <0.001乙肝和4.71±2.03与3.42±1.49; P <丙型肝炎0.05），而国王的得分（24.31±3.14与7.65±6.70; P <0.001乙肝和24.82±2.55与8.33±7.29; P <0.001丙型肝炎）。有在AAR的乙型肝炎和丙型肝炎的病人之间高，低纤维化（无显著差异0.78±0.31对0.74±0.34; P = 0.082乙型肝炎和0.91±0.40对0.85±0.27; P = 0.25丙型肝炎）。该APind的受试者工作特征曲线下面积，APRI，CDS和国王的得分乙肝组分别为0.767，0.710，0.646，0.770和分别;这些值分别为0.732，0.763，0.677，和0.783，分别在丙型肝炎组。

结论：总之，我们的数据表明，四个在本研究评价了5无创方法可用于预测患者的肝炎B和C但是晚期肝纤维化，有肝纤维化的程度和按照AAR之间没有显著关系得分，表示AAR不在估计乙型和丙型肝炎的患者的纤维化阶段是有用的。

zgct

看不太明白

jiankangren19

意识是不是说那个Alt与血小板比值预测肝硬化和纤维化方面不准确吧！其实早就知道不准确了，上次好多肝硬化的网友用这个公式测出来都正常，结果自己都硬化好多年了。