炎症指标对慢性乙型肝炎显着肝纤维化患者的预后价值：中

StephenW

炎症指标对慢性乙型肝炎显着肝纤维化患者的预后价值：中国多中心研究
张秀娟1号玉生街2号泽民湾3号杉杉林1号应贤李4号明林1号吴书铎1号吴小菊1号梅杰史1号黄明晓1号民令曹1号焦公5号小玲池1
隶属关系
隶属关系

    1
    【作者单位】： 广州中医药大学第二附属广东省中医院肝病科;
    2
    广州中山大学附属第三医院感染科。
    3
    广州中医药大学第二附属医院检验科，广州，中国。
    4
    广州中医药大学第二附属医院医学教育科，广州，中国。
    5
    广州中山大学附属第三医院检验科。

    PMID：34858162 PMCID：PMC8631540 DOI：10.3389/fphar.2021.653751

抽象的

显着肝纤维化的诊断对于促进最佳治疗决策和改善慢性乙型肝炎 (CHB) 患者的预后至关重要。我们旨在评估炎症指标的价值并构建一个列线图，以有效预测 CHB 患者的显着肝纤维化。 2014-2019 年中国两个中心的 563 名 CHB 患者被分为三个队列（开发队列、内部验证队列和独立验证队列），分为显着纤维化病例（肝纤维化分期≥2）和无明显纤维化病例。研究了多种生化和血清学炎症指标。炎症指标丙氨酸氨基转移酶 (ALT) 和天冬氨酸氨基转移酶 (AST) 与 CHB 患者的显着肝纤维化显着相关但预测性能有限，然后我们将它们与凝血酶原时间活动百分比 (PTA) 和肝脏硬度测量 (LSM) 结合起来通过多变量逻辑回归分析确定。基于这些因素，我们构建了性能优异的列线图。开发、内部验证和独立验证队列中列线图的受试者工作特征曲线下面积 (AUROC) 分别为 0.860、0.877 和 0.811。我们构建了基于 ALT 和 AST 的列线图，该列线图在预测 CHB 患者的显着纤维化方面具有出色的性能。

关键词：慢性乙型肝炎；诊断;炎症指标；肝纤维化;预测工具。

版权所有 © 2021 Zhang, Jie, Wan, Lin, Li, Lin, Wu, Wu, Shi, Xiao, Cao, Gong and Chi。

StephenW

Prognostic Value of Inflammatory Indicators in Chronic Hepatitis B Patients With Significant Liver Fibrosis: A Multicenter Study in China
Xiujuan Zhang  1 , Yusheng Jie  2 , Zemin Wan  3 , Shanshan Lin  1 , Yingxian Li  4 , Ming Lin  1 , Shuduo Wu  1 , Xiaoju Wu  1 , Meijie Shi  1 , Huanming Xiao  1 , Minling Cao  1 , Jiao Gong  5 , Xiaoling Chi  1
Affiliations
Affiliations

    1
    Department of Hepatology Diseases, Guangdong Provincial Hospital of Chinese Medicine Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
    2
    Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
    3
    Department of Laboratory Medicine, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
    4
    Department of Medical Education, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
    5
    Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

    PMID: 34858162 PMCID: PMC8631540 DOI: 10.3389/fphar.2021.653751

Abstract

Diagnosis of significant liver fibrosis is essential to facilitate the optimal treatment decisions and improve prognosis in patients with chronic hepatitis B (CHB). We aimed to evaluate the value of inflammatory indicators and construct a nomogram that effectively predicts significant liver fibrosis among CHB patients. 563 CHB patients from two centers in China from 2014 to 2019 were divided into three cohorts (development, internal validation, and independent validation cohorts), assigned into cases with significant fibrosis (liver fibrosis stages ≥2) and those without. Multiple biochemical and serological inflammatory indicators were investigated. Inflammatory indicators, Alanine aminotransferase (ALT) and aspartate aminotransferase (AST), were significantly associated with significant liver fibrosis in CHB patients but limited predictive performance, and then we combined them with prothrombin time activity percentage (PTA) and liver stiffness measurement (LSM) were identified by multivariate logistic regression analysis. Based on these factors, we constructed the nomogram with excellent performance. The area under the receiver operating characteristic curve (AUROC) for the nomogram in the development, internal validation, and independent validation cohorts were 0.860, 0.877, and 0.811, respectively. Our nomogram based on ALT and AST that had excellent performance in predicting significant fibrosis of CHB patients were constructed.

Keywords: chronic hepatitis B; diagnosis; inflammatory indicators; liver fibrosis; predicting tool.

Copyright © 2021 Zhang, Jie, Wan, Lin, Li, Lin, Wu, Wu, Shi, Xiao, Cao, Gong and Chi.

StephenW

https://www.frontiersin.org/articles/10.3389/fphar.2021.653751/pdf