兰州大学学报（医学版）2024，Vol.50Issue(3)：35-43,9.DOI:10.13885/j.issn.1000-2812.2024.03.006
基于肝活检比较肝硬度值和血清学模型对慢性乙型肝炎获得持续病毒学应答人群肝纤维化的诊断效能
To compare the diagnostic efficacy of liver stiffness measurement and serological model for liver fibrosis in CHB patients with maintained virologic response based on liver biopsy
摘要
Abstract
Objective Based on the Scheuer score of liver pathology,to compare the diagnostic efficacy of liver stiffness measurement(LSM)and serological models for liver fibrosis stage in patients with chronic hepatitis B(CHB)who have maintained virologic response(MVR).Methods A total of 86 CHB patients with MVR,normal alanine aminotransferase and Scheuer score(G<2)were enrolled.LSM,aspartate aminotrans ferase to platelet ratio index,fibrosis index based on four factors,aspartate alanine aminotransferase ratio,gamma-glutamyl transpeptidase to platelet ratio,S index,AGAP score,King's index,and Forns index were collected and calculated.According to the Scheuer score of liver biopsy,35 cases had mild fibrosis:1≤S<2,41 cases had significant fibrosis:2≤S≤3,and 10 cases had advanced fibrosis:3<S≤4.Spearman correlation study was performed between the Scheuer stage and LSM and serological models.The area under the curve(AUC)of the receiver operating characteristic was used to compare the diagnostic efficacy of LSM and sero-logical models for S≥2 and S≥3,and a subgroup analysis was performed to explore the diagnostic efficacy of LSM and serological models for different hepatitis B e antigen(HBeAg)states.Results The baseline data of noninvasive fibrosis indicators were of statistically significant differences between the three groups(P<0.05).Except for the aspartate alanine aminotransferase ratio,LSM and serological models were positively correlated with the Scheuer stage,and LSM had the largest correlation(rs = 0.615,P<0.001).In Scheuer stage S≥2 and S≥3,LSM-AUC(0.818 and 0.887)were higher than the serological models,especially when S≥3,the difference was statistically significant(P<0.05).AGAP score and S index,and LSM combination-AUC(0.905)were higher than independent LSM AUC(0.887),but no statistical difference was shown(P = 0.313).At the Scheuer stage S≥2 and S≥3,the AUC of LSM in HBeAg negative group was higher than the HBeAg-positive group.Conclusion The diagnosing efficacy of LSM in patients with CHB-MVR was higher than oth-er serological models,especially for HBeAg negative CHB-MVR patients.However,the stability of LSM in evaluating the dynamic progression of hepatic fibrosis needs to be further verified by long-term cohort studies.关键词
慢性乙型肝炎/持续病毒学应答/肝硬度值/肝纤维化/血清学指标/诊断Key words
chronic hepatitis B/maintained virologic response/liver stiffness measurement/hepatic fibrosis/serological indicator/diagnosis分类
医药卫生引用本文复制引用
张春霞,王亮,刘天府,李娟,刘元元,裴志燕,张岭漪..基于肝活检比较肝硬度值和血清学模型对慢性乙型肝炎获得持续病毒学应答人群肝纤维化的诊断效能[J].兰州大学学报（医学版）,2024,50(3):35-43,9.基金项目
甘肃省教育科技创新资助项目(2022B-047) （2022B-047）
兰州大学第二医院"萃英科技创新"计划资助项目(CY2021-QN-A18) （CY2021-QN-A18）
