验证白蛋白，胆红素和血小板标准，以避免对晚期纤维化患

StephenW

Validation of Albumin, Bilirubin, and Platelet Criteria for Avoiding Screening Endoscopy in Patients With Advanced Fibrosis
Nobuharu Tamaki  1 , Masayuki Kurosaki  1 , Mayu Higuchi  1 , Sakura Kirino  1 , Kento Inada  1 , Koji Yamashita  1 , Shuhei Sekiguchi  1 , Yuka Hayakawa  1 , Leona Osawa  1 , Kenta Takaura  1 , Chiaki Maeyashiki  1 , Shun Kaneko  1 , Yutaka Yasui  1 , Kaoru Tsuchiya  1 , Hiroyuki Nakanishi  1 , Jun Itakura  1 , Namiki Izumi  1
Affiliations

    PMID: 32515534 DOI: 10.1111/hepr.13533

Abstract

Aim: The albumin, bilirubin, and platelet (ABP) criteria was proposed to avoid screening endoscopy for detecting high-risk varices (HRV) and it has high diagnostic accuracy. We conducted the retrospective cross-sectional study to verify the diagnostic accuracy.

Methods: A total of 610 patients with advanced fibrosis were enrolled in the study. ABP criteria is defined as follows; albumin > 4.0g/dl, bilirubin < 22μmol/l, and platelet > 114,000/μl.

Results: Background liver disease were hepatitis C/hepatitis B/nonalcoholic fatty liver disease (NAFLD) /others:405 (66.4%) / 67 (10.5%) /78 (12.8%) /60 (10.3%). One hundred five patients (17.2%) had HRV. In multivariate analysis, serum bilirubin < 22μmol/l [hazard ratio (HR): 2.00, 95% confidence interval (95%CI): 1.2-3.4], albumin > 4.0g/dl (HR: 2.56, 95%CI: 1.7-3.8), and platelet > 114,000/μl (HR: 3.52, 95%CI: 2.1-5.8) levels were independently associated with no presence of HRV. When examined ABP criteria, 200 patients (32.8%) fulfilled the criteria, and 194 patients had no HRV (positive predictive value [PPV]: 97.0%) When classified by etiologies (hepatitis C/hepatitis B/nonalcoholic fatty liver disease), PPV were 97.7/100/92.0%, respectively.

Conclusions: ABP criteria is easy to examine because it uses only standard laboratory tests, and it can be available to screening patients who might avoid endoscopy regardless of etiologies.

Keywords: ABP criteria; cirrhosis; gastroesophageal varices.

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StephenW

验证白蛋白，胆红素和血小板标准，以避免对晚期纤维化患者进行内镜检查
玉伸信1，黑崎昌纪1，口麻友1，樱麒麟1，稻田健太1，山下浩二1，关口筑平1，早川由香1，小泽莉娜1，高田健太郎1，千秋前纪1，顺金子1，隆康1，土屋薰1，中西博之1，板仓淳1，泉南木1
隶属关系

    PMID：32515534 DOI：10.1111 / hepr.13533

抽象

目的：提出白蛋白，胆红素和血小板（ABP）标准是为了避免筛查内窥镜检查高风险静脉曲张（HRV），并且具有较高的诊断准确性。我们进行了回顾性横断面研究，以验证诊断的准确性。

方法：共纳入610例晚期纤维化患者。 ABP标准定义如下：白蛋白> 4.0g / dl，胆红素<22μmol/ l，血小板> 114,000 /μl。

结果：背景肝病为丙型肝炎/乙型肝炎/非酒精性脂肪肝（NAFLD）/其他：405（66.4％）/ 67（10.5％）/ 78（12.8％）/ 60（10.3％）。一百零五名患者（17.2％）患有HRV。在多变量分析中，血清胆红素<22μmol/ l [危险比（HR）：2.00，95％置信区间（95％CI）：1.2-3.4]，白蛋白> 4.0g / dl（HR：2.56，95％CI：1.7 -3.8）和> 114,000 /μl（HR：3.52，95％CI：2.1-5.8）的血小板水平独立地与不存在HRV有关。按ABP标准进行检查时，有200例患者（32.8％）符合标准，而194例患者无HRV（阳性预测值[PPV]：97.0％）按病因分类（丙型肝炎/乙型肝炎/非酒精性脂肪肝），PPV分别为97.7 / 100 / 92.0％。

结论：ABP标准易于检查，因为它仅使用标准的实验室检查，并且可以用于筛查无论病因如何均避免内镜的患者。

关键词：ABP标准；肝硬化胃食管静脉曲张。

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