γ-谷氨酰转移酶与血小板比率和FIB-4评分是确定慢性乙型肝

StephenW

Br J Biomed Sci. 2018 Jun 12:1-5. doi: 10.1080/09674845.2018.1459147. [Epub ahead of print]
The gamma-glutamyl transferase to platelet ratio and the FIB-4 score are noninvasive markers to determine the severity of liver fibrosis in chronic hepatitis B infection.
Lee J1, Kim MY2, Kang SH2, Kim J1, Uh Y1, Yoon KJ1, Kim HS3.
Author information

1
    a Department of Laboratory Medicine , Yonsei University Wonju College of Medicine , Wonju , Korea.
2
    b Department of Internal Medicine , Yonsei University Wonju College of Medicine , Wonju , Korea.
3
    c Department of Laboratory Medicine , Yonsei University College of Medicine , Seoul , Korea.

Abstract

Objective Noninvasive liver fibrosis evaluation is an important issue in chronic hepatitis B infection, and may be assessed using transient elastography (Fibroscan) or with blood markers. We compared the value of Fibroscan with that of a panel of routine serum markers. Materials and methods We recruited 278 chronic hepatitis B patients who underwent Fibroscan and HBV DNA testing. Fibroscan assessments were made, and blood taken for the measurement of the gamma-glutamyl transferase (GGT) to platelet ratio (GPR), platelet count, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), international normalised ratio (INR), total cholesterol, trigylcerides, bilirubin, mean platelet volume (MPV), AST to platelet ratio index (APRI) and neutrophil to lymphocyte ratio. Results A fibrosis index based on four factors (FIB-4) and GPR were higher and platelets were lower in mild liver fibrosis than in non-liver fibrosis. GGT, AST, ALT, INR, MPV, APRI, FIB-4, GPR, and NLR were higher, and platelet and cholesterol were lower in severe liver fibrosis than in mild liver fibrosis. Elevated GPR (Odds ratio 95% CI 9.1 [1.66-50.0] p = 0.011) and FIB-4 (2.3 [1.2-4.2], p = 0.01) were associated with greater risk of liver fibrosis. The areas under the curve (AUC) were for GPR 0.84 at a cut-off of 0.299 and for FIB-4 0.82 at cut-off 1.571. Conclusions FIB-4 and GPR may be useful blood markers for evaluating the severity of liver fibrosis in chronic hepatitis B patients. Further prospective study is required to validate these noninvasive blood markers in a clinical practice.
KEYWORDS:

Liver fibrosis; chronic hepatitis B; noninvasive markers; transient elastography

PMID:
    29893189
DOI:
    10.1080/09674845.2018.1459147

StephenW

Br J Biomed Sci。 2018年6月12日：1-5。 doi：10.1080 / 09674845.2018.1459147。 [电子版提前打印]
γ-谷氨酰转移酶与血小板比率和FIB-4评分是确定慢性乙型肝炎感染中肝纤维化严重程度的非侵入性标志物。
Lee J1，Kim MY2，Kang SH2，Kim J1，Uh Y1，Yoon KJ1，Kim HS3。
作者信息

1
    韩国原州市延世大学原州医学院检验医学系。
2
    b韩国原州延世大学原州医学院内科学系。
3
    c韩国首尔延世大学医学院检验医学系。

抽象

目的无创性肝纤维化评估是慢性乙型肝炎感染的一个重要问题，可以使用瞬时弹性成像（Fibroscan）或血标记进行评估。我们比较了Fibroscan的价值与一组常规血清标志物的价值。材料和方法我们招募了278名接受Fibroscan和HBV DNA检测的慢性乙型肝炎患者。进行Fibroscan评估，并采集血液测量γ-谷氨酰转移酶（GGT）与血小板比率（GPR），血小板计数，天冬氨酸氨基转氨酶（AST），丙氨酸氨基转氨酶（ALT），国际标准化比值（INR）胆固醇，三酸甘油酯，胆红素，平均血小板体积（MPV），AST与血小板比指数（APRI）以及嗜中性粒细胞与淋巴细胞的比率。结果轻度肝纤维化患者纤维化指数（FIB-4）和GPR均高于非肝纤维化患者，纤维化指数较高，血小板较低。 GGT，AST，ALT，INR，MPV，APRI，FIB-4，GPR和NLR均较高，严重肝纤维化患者的血小板和胆固醇水平低于轻度肝纤维化患者。 GPR升高（比值比95％CI 9.1 [1.66-50.0] p = 0.011）和FIB-4（2.3 [1.2-4.2]，p = 0.01）与肝纤维化风险增加有关。曲线下面积（AUC）为截止值0.299处的GPR 0.84和截止点1.571处的FIB-4 0.82。结论FIB-4和GPR可作为评估慢性乙型肝炎患者肝纤维化严重程度的有用指标。在临床实践中需要进一步的前瞻性研究来验证这些非侵入性血液标记物。
关键词：

肝纤维化;慢性乙型肝炎;无创标记物;瞬时弹性成像

结论：
    29893189
DOI：
    10.1080 / 09674845.2018.1459147