γ-谷氨酰转肽酶对血小板比指数是预测中国慢性乙型肝炎肝

StephenW

J Int Med Res. 2016 Dec;44(6):1302-1313. doi: 10.1177/0300060516664638. Epub  2016 Nov 11.
Gamma-glutamyl transpeptidase to platelet ratio index is a good noninvasive biomarker for predicting liver fibrosis in Chinese chronic hepatitis B patients.Wang RQ1, Zhang QS1, Zhao SX1, Niu XM1, Du JH1, Du HJ1, Nan YM1.
Author information
1Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China.

AbstractObjective To evaluate whether gamma-glutamyl transpeptidase to platelet ratio index (GPRI) can diagnose the extent of liver fibrosis in Chinese patients with chronic hepatitis B (CHB) infection. Methods This prospective observational study used liver biopsy results as the gold standard to evaluate the ability of GPRI to predict hepatic fibrosis compared with two other markers, the aspartate aminotransferase (AST) to platelet ratio index (APRI) and fibrosis-4 score (FIB-4). The clinical and demographic factors that affected GPRI, independent of liver fibrosis, were assessed using multivariate linear regression analyses. Results This study enrolled 312 patients with CHB. GPRI had a significantly positive correlation with liver fibrosis stage and the correlation coefficient was higher than that for APRI and FIB-4. The areas under the receiver operating curves for GPRI for significant fibrosis, bridging fibrosis, and cirrhosis were 0.728, 0.836, and 0.842, respectively. Of the three indices, GPRI had the highest diagnostic accuracy for bridging fibrosis and cirrhosis. Age, elevated AST and elevated total bilirubin levels were independent determinants of increased GPRI. Conclusion GPRI was a more reliable laboratory marker than APRI and FIB-4 for predicting the stage of liver fibrosis in Chinese patients with CHB.


KEYWORDS: Noninvasive biomarker; aspartate aminotransferase to platelet ratio index; chronic hepatitis B; fibrosis-4 score; gamma-glutamyl transpeptidase to platelet ratio index; liver fibrosis

PMID:28322102DOI:10.1177/0300060516664638

StephenW

J Int Med Res。 2016年12月44（6）：1302-1313。 Doi：10.1177 / 0300060516664638. Epub 2016 Nov 11。
γ-谷氨酰转肽酶对血小板比指数是预测中国慢性乙型肝炎肝纤维化的良好非侵入性生物标志物。
王RQ1，张QS1，赵SX1，牛XM1，杜JH1，杜HJ1，南YM1。
作者信息

1
河北医科大学第三医院传统西医肝病科，河北石家庄市。

抽象

目的评价任何γ-谷氨酰转肽酶血小板比值指数（GPRI）可诊断中国慢性乙型肝炎（CHB）感染患者肝纤维化程度。方法本研究采用肝脏活检结果作为黄金标准，评估GPRI预测肝纤维化的能力，与其他两种标志物相比，天冬氨酸氨基转移酶（AST）与血小板比指数（APRI）和纤维化4评分（FIB- 4）。影响GPRI的临床和人口学因素，与肝纤维化无关，使用多变量线性回归分析。结果本研究纳入了312例CHB患者。 GPRI与肝纤维化程度呈显着正相关，相关系数高于APRI和FIB-4。受体操作曲线下的区域GPRI显着纤维化，桥联纤维化和肝硬化分别为0.728,0.836和0.842。在三个指标S中，GPRI具有桥接纤维化和肝硬化的最高诊断准确性。年龄，AST升高和总胆红素水平升高是增加GPRI的独立决定因素。 GPRI是用于预测中国CHB患者肝纤维化分期的APRI和FIB-4的计算标记物。
关键词：

无创生物标志物;天冬氨酸转氨酶至血小板比指数;慢性乙型肝炎纤维化4评分; γ-谷氨酰转肽酶至血小板比指数;肝纤维化

PMID：
28322102
DOI：
10.1177 / 0300060516664638

tacolynn

去百度了一下，确实有这方面的临床对比研究。不光是γ-谷氨酰转肽酶与血小板比值指数，也包括AST/血小板数值。

但是这种非侵入性诊断肝纤维化的可靠性，个人觉得还是比较模糊。比如我老公的情况，GGT/PLT,  AST/PLT, 以及那个FIB-4评分，三项都说没有纤维化。但是飞波肝硬度8.5，B超回声增粗增强分布不均，门静脉12，医生说中度纤维化。

tacolynn

大家可以自测一下，从百度中搜到的研究文章，AST/血小板数值，异常值上限是＞0.25，GGT/血小板数值，异常值上限＞0.21.

AST/血小板，≤0.5不存在纤维化，≤1不存在肝硬化。＞1.5可准确预测肝纤维化，＞2可准确预测肝硬化。