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APRI和Forns指数对慢乙肝肝纤维化的诊断价值 预览 被引量:6

The diagnostic value of APRI and Forns index for liver fibrosis of chronic hepatitis B
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摘要 目的验证APRI和Foms指数对诊断慢乙肝肝纤维化的临床价值。方法172例慢性乙肝患者均接受肝组织病理检查,并同时检测肝功能、血常规和血脂,用ROC曲线评价APRI和Foms指数诊断慢乙肝肝纤维化的能力。结果肝纤维化分期与APRI/Foms指数的相关系数分别是0.312和0.315(P〈0.01);肝纤维化S4的APRI和Fores指数均高于S0/S1/S2/S3(P〈0.05);ROC曲线分析显示APRI和Fores指数诊断显著肝纤维化(S2-S4)的AUC均小于0.7,诊断S4的AUC均大于0.7;APRI诊断S4的敏感性(SN)80%、特异性(SP)74%、阳性预测值(PPV)34.5%和阴性预测值(NPV)95.6%;Fores指数诊断S4的SN92%、SP63%、PPV29.9%和NPV97.9%。结论APRI和Fores指数与肝纤维化分期均有一定的相关性,可以用于肝纤维化S4的诊断,但对肝纤维化S1、S2和S3的区分能力有限。 Objective To testify the clinical value of APRI and Forns index diagnosis liver fibrosis of chronic hepatitis B. Methods There were 172 patients with chronic hepatitis B who were underwent liver biopsy with their liver function, blood routine and blood fat taken simultaneously. Three different endpoints were studied according to liver fibrosis stage, namely without/ light fibrosis ( SO/S1 ), significant fibrosis ( S2/S3/S4 ) and cirrhosis ( S4 ). The area under the ROC curves(AUC) reflected its diagnostic values. Results The correlation coefficient between liver fibrosis stage and APRI/ Fores index was 0. 312 and 0. 315, respectively (P 〈 0. 01 ). The APRI and Forns index of fibrosis S4 were higher than those of SO, S1, S2 and S3 ( P 〈 0. 05 ). The AUC for significant fibrosis of APRI/Forns index was low to 0. 7 while that for cirrhosis was high to 0. 7. The sensitivity (SN), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) of APRI evaluating cirrhosis (S4) were 80% , 74% ,34. 5% and 95.6% , respectively, while those of Forns index were 92% ,63% , 29. 9% and 97.9% , respectively. Conclusion There is correlation between liver fibrosis stage and APRI/Forns index. APRI/Forns index can valuate fibrosis S4 in patients with chronic hepatitis B, however, it can not discriminate fibrosis S1, S2 and S3.
作者 蒋忠胜 温小凤 柯柳 覃川 陈念 李敏基 JIANG Zhong - sheng, WEN Xiao -feng, KE Liu, et al. ( The Infectious Diseases Department, the Fifth Affiliated Hospital of Guangxi Medical University ( The peopled hospital of Liuzhou city), Liuzhou Guangxi, 545001, China)
出处 《临床肝胆病杂志》 CAS 2008年第6期423-425,共3页 Chinese Journal of Clinical Hepatology
基金 广西卫生厅自筹经费计划课题(Z2008398).
关键词 慢性乙型病毒性肝炎 肝纤维化 受试者工作特性曲线 chronic hepatitis B liver fibrosis the receiver operating characteristic curve (ROC)
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