同济大学学报（医学版）2018，Vol.39Issue(3)：64-69,6.DOI:10.16118/j.1008-0392.2018.03.012
GPR、APRI和FIB-4预测HBeAg阴性乙型肝炎相关肝纤维化程度的评价
Comparison of GPR, APRI and FIB-4 in predicting severity of liver fibrosis associated with HBeAg-negative chronic hepatitis B
摘要
Abstract
Objective To compare GPR ( γ-glutamyl transpeptidase to platelet ratio ) , APRI ( aspartate aminotransferase to platelet ratio index) and FIB-4 ( fibrosis index based on the 4 factors) in predicting the severity of liver fibrosis associated with HBeAg-negative chronic hepatitis B ( CHB). Methods Total 859 patients with HBeAg-negative chronic hepatitis B were randomly divided into training set ( n＝578) and validation set ( n＝281). With reference to the Scheuer liver pathological scoring system, pathological stage≥S2,≥S3 and ≥S4 were defined as significant, extensive and advanced fibrosis. Results There were no significant differences in the prevalence of the significant, extensive and advanced fibrosis between training set and validation set ( P＞ 0. 05). There were no significant differences in the areas under the ROC curves ( AUROCs) of GPR, APRI and FIB-4 in predicting the significant, extensive and advanced fibrosis between training set and validation set ( P＞0. 05). In the training set, the AUROCs of GPR and APRI in predicting significant fibrosis, and AUROCs of GPR, APRI and FIB-4 in predicting extensive and advanced fibrosis were greater than 0. 750 ( the lower limits of 95%CI＞0. 700) ; and the AUROC of FIB-4 in predicting significant fibrosis was 0. 700-0. 750 ( the lower limit of 95%CI＜0. 700). In the validation set, the AUROC of GPR in predicting significant fibrosis, and the AUROCs of GPR, APRI and FIB-4 in predicting extensive fibrosis, and the AUROCs of GPR and FIB-4 in predicting advanced fibrosis were greater than 0. 750 ( the lower limits of 95%CI＞0. 700) ; and the AUROCs of APRI in predicting extensive and advanced fibrosis were 0. 700-0. 750 ( the lower limits of 95%CI＜0. 700) ; and the AUROC of FIB-4 in predicting significant fibrosis was ＜0. 700. Conclusion In the framework of HBeAg-negative CHB patients, GPR and APRI in predicting the significant fibrosis, GPR and FIB-4 in predicting extensive and advanced fibrosis have moderate predictive efficiency and good reliability; while FIB-4 in predicting the significant fibrosis and APRI in predicting the advanced fibrosis have relatively low efficiency.关键词
慢性乙型肝炎/纤维化/无创诊断/GPR/APRI/FIB-4Key words
chronic hepatitis B/fibrosis/noninvasive diagnosis/gamma-glutamyl transpeptidase-to-platelet ratio/aspartate aminotransferase-to-platelet ratio index/fibrosis index based on the 4 factors分类
医药卫生引用本文复制引用
李秀芬,陆伟,潘云鹤,汪洁,张占卿..GPR、APRI和FIB-4预测HBeAg阴性乙型肝炎相关肝纤维化程度的评价[J].同济大学学报（医学版）,2018,39(3):64-69,6.基金项目
上海市市级医院新兴前沿技术联合攻关项目(SHDC12016237) （SHDC12016237）
国家"十二五"传染病科技重大专项(2013ZX10002005) （2013ZX10002005）
