使用天冬氨酸氨基转移酶对血小板比例减少，需要FibroScan评

StephenW

World J Hepatol. 2017 Jun 18;9(17):791-796. doi: 10.4254/wjh.v9.i17.791.
Use of aspartate aminotransferase to platelet ratio to reduce the need for FibroScan in the evaluation of liver fibrosis.Wong S1, Huynh D1, Zhang F1, Nguyen NQ1.
Author information
1Stephanie Wong, Dep Huynh, Frank Zhang, Nam Q Nguyen, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide 5000, Australia.

AbstractAIM: To evaluate the performance of aspartate aminotransferase to platelet ratio (APRI) score against FibroScan in predicting the presence of fibrosis.
METHODS: Data of patients who concurrently had APRI score, FibroScan and liver biopsy to assess their hepatitis C virus (HCV) and hepatitis B virus (HBV) over 6 years were retrospectively reviewed and details of their disease characteristics and demographics were recorded. Advanced fibrosis was defined as ≥ F3.
RESULTS: Of the 3619 patients (47.5 ± 11.3 years, 97M:36F) who had FibroScans and APRI for HCV and HBV, 133 had concurrent liver biopsy. Advanced liver fibrosis was found in 27/133 (20%, F3 = 21 and F4 = 6) patients. Although APRI score (P < 0.001, AUC = 0.83) and FibroScan (P < 0.001, AUC = 0.84) predicted the presence of advanced fibrosis, the sensitivities and specificities were only modest (APRI score: 51.9% sensitivity, 84.9% specificity; FibroScan: 63% sensitivity, 84% specificity). Whilst 13/27 (48%) patients with advanced fibrosis had APRI ≤ 1.0, no patients with APRI ≤ 0.5 had advanced fibrosis, with 100% sensitivity. The use of APRI ≤ 0.5 would avoid the need for FibroScan in 43% of patients.
CONCLUSION: APRI score and FibroScan performed equally well in predicting advanced fibrosis. A proposed APRI cut-off score of 0.5 could be used as a screening tool for FibroScan, as cut-off score of 1.0 will miss up to 48% of patients with advanced fibrosis. Further prospective validation studies are required to confirm this finding.


KEYWORDS: Aspartate aminotransferase to platelet ratio; FibroScan; Liver fibrosis; Utilization

PMID:28660013PMCID:PMC5474725DOI:10.4254/wjh.v9.i17.791

StephenW

世界J肝蛋白2017年6月18日; 9（17）：791-796。 doi：10.4254 / wjh.v9.i17.791。
使用天冬氨酸氨基转移酶对血小板比例减少，需要FibroScan评估肝纤维化。
王S1，胡永D1，张F1，阮NQ1。
作者信息

1
    Stephanie Wong，Dep Huynh，Frank Zhang，Nam Q Nguyen，Department of Gastroenterology and Hepatology，Royal Adelaide Hospital，Adelaide 5000，Australia。

抽象
目标：

评估天冬氨酸氨基转移酶对血小板比（APRI）评分对FibroScan的预测纤维化存在的表现。
方法：

对患者同时进行APRI评分，FibroScan和肝活检评估6年以上丙型肝炎病毒（HCV）和乙型肝炎病毒（HBV）患者的资料进行回顾性回顾，并记录其疾病特征和人口统计学细节。高级纤维化定义为≥3F。
结果：

在3619例患有FibroScans和APRI的HCV和HBV患者（47.5±11.3岁，97M：36F）中，133例并发肝活检。在27/133（20％，F3 = 21和F4 = 6）患者中发现先进的肝纤维化。虽然APRI评分（P <0.001，AUC = 0.83）和FibroScan（P <0.001，AUC = 0.84）预测了晚期纤维化的存在，但敏感性和特异度仅为适度（APRI评分：51.9％敏感性，84.9％特异性; FibroScan ：灵敏度63％，特异性84％）。虽然13/27（48％）晚期纤维化患者的APRI≤1.0，但APRI≤0.5的患者没有进展纤维化，100％的敏感性。 APRI≤0.5的使用将避免在43％的患者中需要FibroScan。
结论：

APRI评分和FibroScan在预测晚期纤维化中表现相同。拟议的APRI临床分数为0.5可作为FibroScan的筛选工具，因为1.0的临界分数将会高达48％的晚期纤维化患者。需要进一步的前瞻性验证研究来证实这一发现。
关键词：

天门冬氨酸转氨酶与血小板比例;肝纤维;肝纤维化;采用

结论：
    28660013
PMCID：
    PMC5474725
DOI：
10.4254 / wjh.v9.i17.791