非侵入性模型预测慢性乙型肝炎患者肝损害的比较。

StephenW

Gastroenterol Hepatol. 2019 Feb 13. pii: S0210-5705(19)30025-1. doi: 10.1016/j.gastrohep.2018.12.004. [Epub ahead of print]
Comparison of non-invasive models for predicting liver damage in chronic hepatitis B patients.
[Article in English, Spanish]
Yu K1, Du Z2, Li Q3, Cheng Q1, Huang C1, Shi G1, Li N4.
Author information

1
    Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China.
2
    Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
3
    Department of General Surgery, Qingdao Municipal Hospital, Qingdao 266071, China.
4
    Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China. Electronic address: [email protected].

Abstract
INTRODUCTION:

Inexpensive blood tests have been well established as alternatives to liver biopsies to evaluate liver fibrosis in CHB patients. Here, we aim to compare their diagnostic accuracy in assessing liver fibrosis and necroinflammation.
PATIENTS AND METHODS:

A retrospective study was performed to evaluate the predictive value of non-invasive models in chronic hepatitis B patients with liver fibrosis by the area under receiver operating characteristic curve (AUROC). The clinical data of 160 patients were collected from medical records.
RESULTS:

Of the 160 consecutive treatment-naïve CHB patients, 29 (16%) had significant fibrosis and 34 (21%) had severe necroinflammation. The AUROC of the gamma-glutamyl transpeptidase to platelet ratio (GPR) (0.761, 95% CI 0.671-0.850) for predicting significant fibrosis was significantly higher than that of the aspartate transaminase-to-platelet ratio index (APRI) (0.680, 95% CI 0.585-0.774, p=0.034), but comparable with the fibrosis index based on four factors (Fib-4) (0.746, 95% CI 0.656-0.836, p=0.703), while for predicting severe necroinflammation, the performance of the GPR (AUROC=0.869, 95% CI 0.800-0.937) was better than the APRI (AUROC=0.816, 95% CI 0.740-0.892, p=0.085) and Fib-4 (0.792, 95% CI 0.711-0.873, p=0.023).
DISCUSSION:

GPR is a satisfactory model to stage liver fibrosis and to grade necroinflammation activity, representing a convenient non-invasive alternative to liver biopsy in China.

Copyright © 2019. Publicado por Elsevier España, S.L.U.
KEYWORDS:

Fibrosis hepática; Liver fibrosis; Modelo no invasivo; Necroinflamación; Necroinflammation; Noninvasive model

PMID:
    30772087
DOI:
    10.1016/j.gastrohep.2018.12.004

StephenW

胃肠道肝炎。 2019年2月13日.pii：S0210-5705（19）30025-1。 doi：10.1016 / j.gastrohep.2018.12.004。 [印刷前的电子版]
非侵入性模型预测慢性乙型肝炎患者肝损害的比较。
[英文，西班牙文]
Yu K1，Du Z2，Li Q3，Cheng Q1，Huang C1，Shi G1，Li N4。
作者信息

1
    复旦大学附属华山医院感染科，上海200040
2
    复旦大学附属华山医院病理科，上海200040
3
    青岛市立医院普外科，山东青岛266071
4
    复旦大学附属华山医院感染科，上海200040电子地址：[email protected]。

抽象
介绍：

已经很好地建立了廉价的血液检查作为肝脏活组织检查的替代方案，以评估CHB患者的肝纤维化。在这里，我们的目的是比较他们在评估肝纤维化和坏死性炎症方面的诊断准确性。
患者和方法：

进行了一项回顾性研究，以评估受试者工作特征曲线（AUROC）下慢性乙型肝炎患者肝纤维化患者的非侵入性模型的预测价值。从病历中收集了160名患者的临床资料。
结果：

在160名连续接受治疗的CHB患者中，29名（16％）患有明显的纤维化，34名（21％）患有严重的坏死性炎症。用于预测显着纤维化的γ-谷氨酰转肽酶与血小板比值（GPR）（0.761,95％CI 0.671-0.850）的AUROC显着高于天冬氨酸转氨酶与血小板比值指数（APRI）（0.680,95） ％CI 0.585-0.774，p = 0.034），但与基于四个因子（Fib-4）的纤维化指数（0.746,95％CI 0.656-0.836，p = 0.703）相比，而对于预测严重的坏死性炎症， GPR（AUROC = 0.869,95％CI 0.800-0.937）优于APRI（AUROC = 0.816,95％CI 0.740-0.892，p = 0.085）和Fib-4（0.792,95％CI 0.711-0.873，p = 0.023）。
讨论：

GPR是一种令人满意的模型，可用于分期肝纤维化和坏死性炎症活动，是中国肝脏活检的一种方便的非侵入性替代方案。

版权所有©2019。Publicse porElsevierEspaña，S.L.U。
关键词：

肝纤维化;肝纤维化; Modelo没有入侵; Necroinflamación;坏死性炎症;无创模型

结论：
    30772087
DOI：
    10.1016 / j.gastrohep.2018.12.004