检验医学与临床2024，Vol.21Issue(2)：237-241,246,6.DOI:10.3969/j.issn.1672-9455.2024.02.022
无创方法诊断HBeAg阳性慢性乙型肝炎患者肝内炎症反应程度
Diagnostic Vslue of Noninvasive method to Predict Liver Inflammation in HBeAg-Positive Hepatitis B Patients
叶雅妹 1周丽娜 1杨文彦 1孙芳 1林勇 1林春 1潘晨1
作者信息
- 1. 福建医科大学孟超肝胆医院代谢性肝病科,福建福州 350000
- 折叠
摘要
Abstract
Objective To establish a model composed of simple routine experimental data to predict the de-gree of liver inflammation response in chronic hepatitis B(CHB)patients with HBeAg positive and alanine aminotransferase(ALT)≤2 times the upper limit of normal.Methods A total of 151 CHB patients with HBeAg postive and ALT≤2 times the upper limit of normal from April 1,2019 to May 8,2021 were selected as the research objects.According to the results of liver pathological examination,they were divided into mild inflammation response[liver tissue inflammation grade(G)0-1]group and moderate inflammation response(G≥2)group.Multivariate Logistic regression was used to analyze the independent risk factors of moderate inflammation in CHB patients and establish a diagnostic model.Results The research object of 53.0％(80/151 cases)appeared G≥2.The levels of ALT and AST in G≥2 group were significantly higher than those in G0-1 group(P＜0.05).The levels of ChE,PA and HBsAg in G≥2 group were significantly lower than those in G0-1 group(P＜0.05).The levels ALT and AST were weakly positively correlated with G grade(r=0.212,0.303,P＜0.05),ChE,PA,HBsAg were negatively and weakly correlated with G grade(r=-0.371,-0.330,-0.173,P＜0.05).High level of AST,low level of PA and low level of logChE were inde-pendent risk factors for moderate inflammation response in CHB patients(P＜0.05).The area under the re-ceiver operating characteristic curve of model CPA for predicting the occurrence of G≥2 was 0.842(95％CI:0.741-0.935).When CPA≤0.3,the negative predictive value of excluding G≥2 was 84.21％.When CPA≥0.6,the positive predictive value of CPA for G≥2 was 84.00％.Conclusion AST,PA and logChE are associ-ated with the degree of intrahepatic inflammation response in CHB patients with HBsAg positive and ALT≤2 times upper limit of normal.CPA has a good diagnostic efficacy for the occurrence of G≥2,and the indica-tors involved in the model are simple and easy to obtain,which is suitable for clinical application.关键词
慢性乙型肝炎/乙型肝炎e抗原/肝穿刺/炎症反应/无创模型Key words
chronic hepatitis B/HBeAg/liver biopsy/inflammation response/noninvasive model分类
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叶雅妹,周丽娜,杨文彦,孙芳,林勇,林春,潘晨..无创方法诊断HBeAg阳性慢性乙型肝炎患者肝内炎症反应程度[J].检验医学与临床,2024,21(2):237-241,246,6.
