同济大学学报（医学版）2018，Vol.39Issue(1)：76-82,7.DOI:10.16118/j.1008-0392.2018.01.015
天冬氨酸转氨酶/胆碱酯酶比值预测慢性乙型肝炎肝纤维化程度的性能评价
Application of aspartate aminotransferase to cholinesterase ratio for predicting hepatic fibrosis in patients with chronic hepatitis B
摘要
Abstract
Objective To evaluate the application of aspartate aminotransferase to cholinesterase ratio (ACR) versus aspartate aminotransferase to platelet ratio(APR) in predicting the severity of hepatic fibrosis in patients with chronic hepatitis B (CHB).Methods Total 1 335 HBeAg positive and 1 026 HBeAg negative patients with CHB were enrolled.According to Scheuer score system,pathological stage ≥ S2 was defined as significant hepatic fibrosis,and ≥ 4 was defined as cirrhosis.The ROC curve was used to assess the value of ACR and APR in predicting the hepatic fibrosis and cirrhosis.Results In HBeAg positive patients,the areas under the ROC curves (AUC) of ACR and APR for predicting significant hepatic fibrosis were 0.772 and 0.765 respectively,and those for predicting cirrhosis were 0.751 and 0.756,respectively;with ACR＞0.200 and APR＞ 1.000 as cutoff values,the sensitivity,specificity of ACR and APR for predicting significant hepatic fibrosis were 60.4％,79.2％ and 56.8％,78.8％,respectively,and those for predicting cirrhosis were 77.3％,61.2％ and 76.2％,63.8％,respectively.In HBeAg negative patients,the AUC of ACR and APR for predicting significant hepatic fibrosis were 0.756 and 0.741 respectively,and those for predicting cirrhosis were 0.805 and 0.786 respectively;with ACR＞0.125 and APR＞0.750 as cutoff values,the sensitivity,specificity of ACR and APR for predicting significant hepatic fibrosis were 59.0％,80.4％ and 58.1％,79.8％,respectively,and those for predicting cirrhosis were 80.7％,68.3％ and 80.2％,68.5％,respectively.Conclusion The cutoff values of ACR and APR for predicting significant hepatic fibrosis and cirrhosis in HBeAg positive patients are inconsistent with those in HBeAg negative patients;the sensitivity and specificity of ACR for predicting significant hepatic fibrosis and cirrhosis are consistent with those of APR regardless of HBeAg positive or negative patients.关键词
天冬氨酸转氨酶/胆碱酯酶比值/天冬氨酸转氨酶/血小板比值/肝纤维化/慢性乙型肝炎/无创诊断Key words
aspartate aminotransferase to cholinesterase ratio/aspartate aminotransferase to platelet ratio/hepatic fibrosis/chronic hepatitis B/noninvasive diagnosis分类
医药卫生引用本文复制引用
黄丹,陆伟,汪洁,张正华,潘云鹤,张占卿..天冬氨酸转氨酶/胆碱酯酶比值预测慢性乙型肝炎肝纤维化程度的性能评价[J].同济大学学报（医学版）,2018,39(1):76-82,7.基金项目
国家“十二五”科技重大专项(2013ZX10002005) （2013ZX10002005）
上海市市级医院新兴前沿技术联合攻关项目(SHDC12016237) （SHDC12016237）
