基于肝脏硬度测量的列线图对乙型肝炎相关显着纤维化和肝

StephenW

Applicability of liver stiffness measurement based nomograms to the assessments of hepatitis B related significant fibrosis and cirrhosis.
Ji SS1, Jiang HD1, Jiang JC1, Li J1, Lin ST1, Chen B1, Xu SH2.
Author information

1
    Department of Ultrasonography, the First Affiliated Hospital of Wenzhou Medical University, China.
2
    Department of Ultrasonography, the First Affiliated Hospital of Wenzhou Medical University, China. Electronic address: [email protected].

Abstract
BACKGROUND:

We evaluated liver fibrosis in patients with chronic hepatitis B (CHB) and mildly raised alanine transaminase (ALT) activities between 1-2 times the upper limit of normal (ULN) which was near the threshold for initiating treatment.
METHODS:

Nomogram-Fibrosis and Nomogram-Cirrhosis were elaborated with variables independently associated with significant fibrosis and cirrhosis determined by multivariate logistic regression. Calibration, receiver operator characteristic (ROC) and decision curves were applied to comparing nomograms with aspartate aminotransferase (AST) to platelet count (PLT) ratio index (APRI), age-AST-PLT-ALT index (FIB-4) and liver stiffness measurement (LSM).
RESULTS:

The Nomogram-Fibrosis was constructed with LSM, PLT, and gamma-glutamyl transpeptidase (GGT). Nomogram-Cirrhosis contained one more variable of age other than Nomogram-Fibrosis. The calibration demonstrated that the assessments of significant fibrosis or cirrhosis by nomograms were in line with liver biopsy. The AUROC of Nomogram-Fibrosis was 0.788, lager than APRI (0.586), FIB-4 (0.656) and LSM (0.735). The AUROC of Nomogram-Cirrhosis was 0.889, larger than APRI (0.642), FIB-4 (0.725) and LSM (0.837). Furthermore, the decision curve analysis suggested the most net benefits were provided by the nomograms.
CONCLUSIONS:

Nomogram-Fibrosis and Nomogram-Cirrhosis could be promising tools for recognizing significant fibrosis and cirrhosis for CHB patients with mild raised ALT activities.

Copyright © 2018. Published by Elsevier B.V.
KEYWORDS:

Cirrhosis; Fibrosis; Hepatitis B; Liver stiffness measurement; Nomogram

StephenW

基于肝脏硬度测量的列线图对乙型肝炎相关显着纤维化和肝硬化的评估的适用性。
Ji SS1，Jiang HD1，Jiang JC1，Li J1，Lin ST1，Chen B1，Xu SH2。
作者信息

1
    温州医科大学附属第一医院超声科。
2
    温州医科大学附属第一医院超声科。电子地址：[email protected]。

抽象
背景：

我们评估慢性乙型肝炎（CHB）患者的肝纤维化和轻度升高的丙氨酸转氨酶（ALT）活性在正常上限（ULN）的1-2倍之间，接近开始治疗的阈值。
方法：

通过多变量逻辑回归确定的独立与显着纤维化和肝硬化相关的变量阐述了Nomogram-Fibrosis和Nomogram-Sprhosis。校准，接受者操作特征（ROC）和决策曲线用于比较诺模图与天冬氨酸氨基转移酶（AST）与血小板计数（PLT）比率指数（APRI），年龄-AST-PLT-ALT指数（FIB-4）和肝硬度测量（LSM）。
结果：

用LSM，PLT和γ-谷氨酰转肽酶（GGT）构建Nomogram-Fibrosis。 Nomogram-Cirrhosis除了Nomogram-Fibrosis之外还包含另外一个年龄变量。校准表明，通过列线图评估显着纤维化或肝硬化与肝脏活检一致。 Nomogram-Fibrosis的AUROC为0.788，大于APRI（0.586），FIB-4（0.656）和LSM（0.735）。 Nomogram-Cirrhosis的AUROC为0.889，大于APRI（0.642），FIB-4（0.725）和LSM（0.837）。此外，决策曲线分析表明，列线图提供的净效益最大。
结论：

Nomogram-Fibrosis和Nomogram-Cirrhosis可用于识别轻度升高的ALT活动的CHB患者的显着纤维化和肝硬化。

版权所有©2018。Elsevier B.V.
关键词：

肝硬化;纤维化;乙型肝炎;肝硬度测量;算图