血小板与门静脉宽度比和血小板与脾脏厚度比可用于预测 HBeA

StephenW

血小板与门静脉宽度比和血小板与脾脏厚度比可用于预测 HBeAg 阴性和正常 ALT 水平的 HBV 感染患者进行性肝纤维化
牡丹峰 1 2 , 蓝磊 2 , 剑旭 3 , 玉智 3 , 杨文峰 3
隶属关系
隶属关系

    1
    【作者单位】： 南充市川北医学院附属医院感染科;
    2
    【作者单位】： 重庆市涪陵中心医院肝病与转化医学科;
    3
    【作者单位】： 重庆市渝北区人民医院感染科;

    PMID：35801214 PMCID：PMC9253570 DOI：10.3389/fmed.2022.837898

抽象的

背景：一些丙氨酸氨基转移酶 (ALT) 水平正常的乙型肝炎病毒 (HBV) 感染者有疾病进展的风险。我们评估了血小板与门静脉宽度比 (PPR) 和血小板与脾脏厚度比 (PSR) 在 HBV e 抗原 (HBeAg) 阴性和 ALT 正常的 HBV 感染患者中预测进行性肝纤维化的价值等级。

方法：纳入 ALT 水平正常的 HBV 表面抗原（HBsAg）阳性和 HBeAg 阴性个体。根据病理特征分析炎症分级(G)和纤维化阶段(S)。然后，根据病理诊断将ALT水平正常的人群分为两组（<S2 vs. ≥S2），并总结临床特征。

结果：142 名 HBsAg 阳性和 HBeAg 阴性患者中有 73 人的 ALT 水平正常。此外，83.56% (61/73) 的个体表现出进行性肝纤维化 (≥S2)。两组之间的 ALT 水平和天冬氨酸氨基转移酶 (AST) 存在差异（分别为 21.01 ± 7.40 对 25.37 ± 7.90 U/L，p = 0.08；29.49 ± 13.56 对 30.16 ± 21.88 U/L，p = 0.92）。门静脉宽度、血清白蛋白和球蛋白水平、AST 与血小板比率指数 (APRI) 和纤维化 4 (FIB-4) 评分在两组之间没有显着差异 (p > 0.05)。两组的血小板计数、PPR 和 PSR 有显着差异[(145.92 ± 14.55) ×109/L vs. (126.38 ± 23.85) ×109/L，p = 0.008； 10.80 ± 1.30 与 9.01 ± 1.97，p = 0.004； 4.21 ± 0.65 与 3.33 ± 0.89，p = 0.02，分别]。 PPR和PSR随着纤维化加重逐渐下降（p < 0.05）。根据 PPR (9.07) 和 PSR (3.54) 的临界值，它们的敏感性和特异性分别为 0.917 和 0.525，以及 0.833 和 0.541。

结论：PPR 和 PSR 可用于评估 HBeAg 阴性且 ALT 水平正常的 HBV 感染患者的早期纤维化进展。

关键词：纤维化阶段；乙型肝炎病毒;正常的 ALT;血小板与门静脉宽度比；血小板与脾脏的厚度比。

版权所有 © 2022 Feng, Lei, Xu, Shi and Yang。

StephenW

Platelet-to-Portal Vein Width Ratio and Platelet-to-Spleen Thickness Ratio Can Be Used to Predict Progressive Liver Fibrosis Among Patients With HBV Infection With HBeAg-Negativity and a Normal ALT Level
Mudan Feng  1   2 , Lan Lei  2 , Jian Xu  3 , Yuzhi Shi  3 , Wenfeng Yang  3
Affiliations
Affiliations

    1
    Department of Infectious Disease, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
    2
    Department of Hepatology and Translation Medicine, Fuling Center Hospital of Chongqing City, Chongqing, China.
    3
    Department of Infectious Disease, The People's Hospital of Yubei District of Chongqing City, Chongqing, China.

    PMID: 35801214 PMCID: PMC9253570 DOI: 10.3389/fmed.2022.837898

Abstract

Background: Some people infected with the hepatitis B virus (HBV) with a normal level of alanine aminotransferase (ALT) are at risk of disease progression. We evaluated the value of platelet-to-portal vein width ratio (PPR) and platelet-to-spleen thickness ratio (PSR) to predict progressive liver fibrosis among patients with HBV infection with HBV e antigen (HBeAg)-negativity and a normal ALT level.

Methods: HBV surface antigen (HBsAg)-positive and HBeAg-negative individuals with a normal ALT level were enrolled. The inflammation grade (G) and fibrosis stage(S) were analyzed according to pathological features. Then, two groups (<S2 vs. ≥S2) among people with a normal ALT level were divided based on the pathological diagnosis, and the clinical characteristics were summarized.

Results: Seventy-three individuals among 142 patients with HBsAg-positivity and HBeAg-negativity had a normal ALT level. Also, 83.56% (61/73) individuals showed progressive liver fibrosis (≥S2). The ALT level and aspartate aminotransferase (AST) between the two groups differed (21.01 ± 7.40 vs. 25.37 ± 7.90 U/L, p = 0.08; 29.49 ± 13.56 vs. 30.16 ± 21.88 U/L, p = 0.92, respectively). Portal-vein width, serum levels of albumin and globulin, AST-to-Platelet Ratio Index (APRI), and Fibrosis 4 (FIB-4) score were not significantly different between the two groups (p > 0.05). The platelet count, PPR, and PSR were significantly different between the two groups [(145.92 ± 14.55) ×109/L vs. (126.38 ± 23.85) ×109/L, p = 0.008; 10.80 ± 1.30 vs. 9.01 ± 1.97, p = 0.004; 4.21 ± 0.65 vs. 3.33 ± 0.89, p = 0.02, respectively]. The PPR and PSR decreased gradually upon fibrosis aggravation (p < 0.05). Based on the cut off value of the PPR (9.07) and PSR (3.54), their sensitivity and specificity was 0.917 and 0.525, and 0.833 and 0.541, respectively.

Conclusion: The PPR and PSR can be employed to assess earlier fibrosis progression among patients with HBV infection with HBeAg-negativity and a normal ALT level.

Keywords: fibrosis stage; hepatitis B virus; normal ALT; platelet-to-portal vein width ratio; platelet-to-spleen thickness ratio.

Copyright © 2022 Feng, Lei, Xu, Shi and Yang.

StephenW

https://www.frontiersin.org/articles/10.3389/fmed.2022.837898/pdf