中国肝脏病杂志（电子版）
中國肝髒病雜誌（電子版）
중국간장병잡지（전자판）
CHINESE JOURNAL OF LIVER DISEASES(ELECTRONIC VERSION)
2013年
2期
50-52
,共3页
肝炎,乙型,慢性%肝纤维化%天冬氨酸氨基转移酶类%血小板计数
肝炎,乙型,慢性%肝纖維化%天鼕氨痠氨基轉移酶類%血小闆計數
간염,을형,만성%간섬유화%천동안산안기전이매류%혈소판계수
Hepatitis B,chronic%Liver fibrosis%Aspartate aminotransferases%Platelet count%Ratio
目的评价天门冬氨酸氨基转移酶（AST）与血小板（PLT）比值在预测慢性乙型肝炎（CHB）肝纤维化分级中的作用。方法将178例CHB合并肝纤维化患者肝组织纤维化程度进行Ishak分期，同时检测患者AST和PLT，计算AST与PLT比值指数（APRI）。比较患者不同肝纤维化分期与APRI间的关系，通过APRI的受试者工作特征（ROC）曲线下面积，分析其预测显著肝纤维化及肝硬化的准确率，并对CHB肝纤维化患者抗病毒治疗前后肝组织纤维化分期和APRI的变化进行对比分析。结果APRI与肝纤维化程度呈正比（P =0.001），APRI预测CHB进展为显著肝纤维化ROC曲线下面积为0.795，而预测肝硬化的ROC曲线下面积为0.714（P =0.003），APRI ＞1.5和＞2分别为显著肝纤维化和肝硬化的截断点，其阳性预测值分别为96%和75%，阴性预测值分别为44%和74%。CHB患者经抗病毒药物治疗后，肝组织学检查结果显示其纤维化程度比治疗前明显减轻，而APRI也明显降低。结论 APRI可作为预测CHB患者发生显著肝纤维化及肝硬化的指标之一。
目的評價天門鼕氨痠氨基轉移酶（AST）與血小闆（PLT）比值在預測慢性乙型肝炎（CHB）肝纖維化分級中的作用。方法將178例CHB閤併肝纖維化患者肝組織纖維化程度進行Ishak分期，同時檢測患者AST和PLT，計算AST與PLT比值指數（APRI）。比較患者不同肝纖維化分期與APRI間的關繫，通過APRI的受試者工作特徵（ROC）麯線下麵積，分析其預測顯著肝纖維化及肝硬化的準確率，併對CHB肝纖維化患者抗病毒治療前後肝組織纖維化分期和APRI的變化進行對比分析。結果APRI與肝纖維化程度呈正比（P =0.001），APRI預測CHB進展為顯著肝纖維化ROC麯線下麵積為0.795，而預測肝硬化的ROC麯線下麵積為0.714（P =0.003），APRI ＞1.5和＞2分彆為顯著肝纖維化和肝硬化的截斷點，其暘性預測值分彆為96%和75%，陰性預測值分彆為44%和74%。CHB患者經抗病毒藥物治療後，肝組織學檢查結果顯示其纖維化程度比治療前明顯減輕，而APRI也明顯降低。結論 APRI可作為預測CHB患者髮生顯著肝纖維化及肝硬化的指標之一。
목적평개천문동안산안기전이매（AST）여혈소판（PLT）비치재예측만성을형간염（CHB）간섬유화분급중적작용。방법장178례CHB합병간섬유화환자간조직섬유화정도진행Ishak분기，동시검측환자AST화PLT，계산AST여PLT비치지수（APRI）。비교환자불동간섬유화분기여APRI간적관계，통과APRI적수시자공작특정（ROC）곡선하면적，분석기예측현저간섬유화급간경화적준학솔，병대CHB간섬유화환자항병독치료전후간조직섬유화분기화APRI적변화진행대비분석。결과APRI여간섬유화정도정정비（P =0.001），APRI예측CHB진전위현저간섬유화ROC곡선하면적위0.795，이예측간경화적ROC곡선하면적위0.714（P =0.003），APRI ＞1.5화＞2분별위현저간섬유화화간경화적절단점，기양성예측치분별위96%화75%，음성예측치분별위44%화74%。CHB환자경항병독약물치료후，간조직학검사결과현시기섬유화정도비치료전명현감경，이APRI야명현강저。결론 APRI가작위예측CHB환자발생현저간섬유화급간경화적지표지일。
Objective To evaluate the aspartate aminotransferase (AST) and platelet (PLT) ratio in predicting classification of chronic hepatitis B (CHB) based on liver fibrosis. Methods Ishak staging of liver fibrosis of 178 cases with CHB was carried out, and AST, PLT levels were detected simutaneously and the ratio of AST and PLT (APRI) was calculated. By anaysis of APRI receiver operating characteristic (ROC) area under the curve, the accuracy of prediction of significant fibrosis and cirrhosis and changes of liver fibrosis and APRI before and after antiviral treatment were analyzed. Results APRI was positively related to the degree of liver fibrosis (P = 0.001). The area under the ROC curve of APRI prediction of CHB progression to significant fibrosis was 0.795, while was 0.714 for prediction of progression to cirrhosis (P = 0.003). The cut-off points of prediction to significant liver fibrosis and cirrhosis was APRI > 1.5 and APRI > 2, with the positive predictive values as 96% and 75%, respectively, and negative value of 44% and 74%, respectively. After antiviral therapy, liver biopsy results of CHB patients confirmed that the degree of fibrosis was significantly improved, and APRI value was also reduced. Conclusions APRI can be taken as a predictor for CHB patients progressing to significant fibrosis and cirrhosis.
