肝硬化测量对慢性乙型肝炎患者丙氨酸转氨酶水平正常或轻

StephenW

Sci Rep. 2018 Mar 27;8(1):5224. doi: 10.1038/s41598-018-23646-2.
Diagnostic accuracy of liver stiffness measurement in chronic hepatitis B patients with normal or mildly elevated alanine transaminase levels.Li Q1,2, Chen L3, Zhou Y4.
Author information
1Department of liver disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China.2Department of Infectious Disease, Huashan Hospital, Fudan University, Shanghai, 200040, China.3Department of liver disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, China. [email protected].4Department of Infectious Disease, Ruian people's hospital, Wenzhou, Zhejiang, 325200, China. [email protected].

AbstractWe aimed to evaluate the diagnostic accuracy of liver stiffness measurement (LSM) in 188 chronic hepatitis B (CHB) patients with alanine transaminase (ALT) ≤ twice the upper limit of normal (ULN). Liver fibrosis was staged using METAVIR scoring system. Define significant fibrosis as F2-F4, severe fibrosis as F3-F4, and cirrhosis as F4. To predict F2-F4, the AUROC of LSM was higher than that of APRI (0.86 vs 0.73, p = 0.001) and FIB-4 (0.86 vs 0.61, p < 0.001). To predict F4, the AUROC of LSM was also higher than that of APRI (0.93 vs 0.77, p = 0.012) and FIB-4 (0.93 vs 0.64, p < 0.001). Patients with ALT levels 1-2 ULN had higher cut-off values than patients with normal ALT levels for the diagnosis of F2-F4 (6.5 vs 6 kPa) and F4 (10.2 vs 7.8 kPa). Using cut-off values regardless of ALT levels, the diagnostic accuracy of LSM was 81% for F2-F4, and 89% for F4. Applying ALT-stratified cut-off values, the diagnostic accuracy of LSM was 82% for F2-F4, and 86% for F4. In conclusion, LSM is a reliable noninvasive test for the diagnosis of liver fibrosis. Applying ALT-stratified cut-off values did not enhance diagnostic accuracy of LSM in CHB patients with ALT ≤ 2 ULN.


PMID:29588489DOI:10.1038/s41598-018-23646-2

StephenW

Sci Rep。2018 Mar 27; 8（1）：5224。 doi：10.1038 / s41598-018-23646-2。
肝硬化测量对慢性乙型肝炎患者丙氨酸转氨酶水平正常或轻​​度升高的诊断准确性。
Li Q1,2，Chen L3，Zhou Y4。
作者信息

1
    复旦大学上海市公共卫生临床中心肝病研究室，上海，201508
2
    复旦大学华山医院感染科，上海，200040
3
    复旦大学上海市公共卫生临床中心肝病研究室，上海，201508 [email protected]。
4
    浙江省温州市瑞安市人民医院感染科，325200 [email protected]。

抽象

我们旨在评估188例慢性乙型肝炎（CHB）丙氨酸转氨酶（ALT）≤正常上限（ULN）两倍的患者肝脏硬度测量（LSM）的诊断准确性。使用METAVIR评分系统分级肝纤维化。将重要的纤维化定义为F2-F4，将严重的纤维化定义为F3-F4，将肝硬化定义为F4。为了预测F2-F4，LSM的AUROC高于APRI（0.86对0.73，p = 0.001）和FIB-4（0.86对0.61，p <0.001）。为了预测F4，LSM的AUROC也高于APRI（0.93对0.77，p = 0.012）和FIB-4（0.93对0.64，p <0.001）。 ALT水平为1-2 ULN的患者诊断F 2 -F 4（6.5与6kPa）和F 4（10.2与7.8kPa）的诊断值比具有正常ALT水平的患者具有更高的截断值。使用截断值而不考虑ALT水平，F2-F4的LSM诊断准确性为81％，F4为89％。应用ALT分层截断值，F2-F4的LSM诊断准确率为82％，F4的诊断准确率为86％。总之，LSM是诊断肝纤维化的可靠的无创检测方法。应用ALT分层临界值并不能提高ALT≤2 ULN的慢性乙型肝炎患者LSM的诊断准确性。

结论：
    29588489
DOI：
    10.1038 / s41598-018-23646-2