山东医药
山東醫藥
산동의약
SHANDONG MEDICAL JOURNAL
2014年
19期
12-14
,共3页
张砚%王春妍%程晓静%刘国旺%侯伟%陆伟
張硯%王春妍%程曉靜%劉國旺%侯偉%陸偉
장연%왕춘연%정효정%류국왕%후위%륙위
肝硬化%病毒性肝炎%乙型肝炎病毒%Fibro Test
肝硬化%病毒性肝炎%乙型肝炎病毒%Fibro Test
간경화%병독성간염%을형간염병독%Fibro Test
Cirrhosis%Viral Hepatitis%Hepatitis B%FibroTest
目的:探讨Fibro Test在慢性乙型肝炎肝纤维化程度判断中的价值。方法留取148例慢性乙型肝炎患者血清,检测α2巨球蛋白(α2M)、结合珠蛋白(HAP)、γ-谷氨酰转肽酶(GGT)、总胆红素(TBIL)和载脂蛋白AⅠ(Apo AⅠ)五个指标,以Fibro Test模型计算FT值,FT=4.467×[lgα2M (g/L)〗-1.357×[lgHAP (g/L)]+1.017×[lgGGT (U/L)]+0.0281×年龄+1.737×[lgTBIL (mol/L)]-1.184×[Apo AⅠ(g/L)]+0.301×性别(男性=1,女性=0)-5.540。受试者均于同期进行肝穿刺活检。以肝穿刺活检病理结果为金标准,绘制出FT值工作特征曲线,计算曲线下面积( AUC),评价其在慢性乙型肝炎肝纤维化程度判断中的价值。结果肝脏病理纤维化分期为S0期4例,S1期59例,S2期41例,S3期31例,S4期13例。显著肝纤维化85例,严重肝纤维化44例,早期肝硬化13例。148例患者的 FT 值为0.616±1.152,其中病理纤维化分期为S0、S1、S2、S3、S4期的 FT值分别为-0.326±0.378、-0.167±1.145、0.906±0.834、1.308±0.516、1.894±0.544,S0、S1、S2、S3、S4期的FT值两两比较,P均<0.05。 FT值与肝脏病理分期呈正相关(r=0.629,P<0.01)。 FT值判断显著肝纤维化、严重肝纤维化及早期肝硬化的AUC分别为0.831、0.889、0.945,cut-off值分别为0.403、0.756、1.385,诊断准确率分别为81.6%、85.5%、91.4%。结论 Fibro Test在慢性乙型肝炎肝纤维化程度判断中有一定价值。
目的:探討Fibro Test在慢性乙型肝炎肝纖維化程度判斷中的價值。方法留取148例慢性乙型肝炎患者血清,檢測α2巨毬蛋白(α2M)、結閤珠蛋白(HAP)、γ-穀氨酰轉肽酶(GGT)、總膽紅素(TBIL)和載脂蛋白AⅠ(Apo AⅠ)五箇指標,以Fibro Test模型計算FT值,FT=4.467×[lgα2M (g/L)〗-1.357×[lgHAP (g/L)]+1.017×[lgGGT (U/L)]+0.0281×年齡+1.737×[lgTBIL (mol/L)]-1.184×[Apo AⅠ(g/L)]+0.301×性彆(男性=1,女性=0)-5.540。受試者均于同期進行肝穿刺活檢。以肝穿刺活檢病理結果為金標準,繪製齣FT值工作特徵麯線,計算麯線下麵積( AUC),評價其在慢性乙型肝炎肝纖維化程度判斷中的價值。結果肝髒病理纖維化分期為S0期4例,S1期59例,S2期41例,S3期31例,S4期13例。顯著肝纖維化85例,嚴重肝纖維化44例,早期肝硬化13例。148例患者的 FT 值為0.616±1.152,其中病理纖維化分期為S0、S1、S2、S3、S4期的 FT值分彆為-0.326±0.378、-0.167±1.145、0.906±0.834、1.308±0.516、1.894±0.544,S0、S1、S2、S3、S4期的FT值兩兩比較,P均<0.05。 FT值與肝髒病理分期呈正相關(r=0.629,P<0.01)。 FT值判斷顯著肝纖維化、嚴重肝纖維化及早期肝硬化的AUC分彆為0.831、0.889、0.945,cut-off值分彆為0.403、0.756、1.385,診斷準確率分彆為81.6%、85.5%、91.4%。結論 Fibro Test在慢性乙型肝炎肝纖維化程度判斷中有一定價值。
목적:탐토Fibro Test재만성을형간염간섬유화정도판단중적개치。방법류취148례만성을형간염환자혈청,검측α2거구단백(α2M)、결합주단백(HAP)、γ-곡안선전태매(GGT)、총담홍소(TBIL)화재지단백AⅠ(Apo AⅠ)오개지표,이Fibro Test모형계산FT치,FT=4.467×[lgα2M (g/L)〗-1.357×[lgHAP (g/L)]+1.017×[lgGGT (U/L)]+0.0281×년령+1.737×[lgTBIL (mol/L)]-1.184×[Apo AⅠ(g/L)]+0.301×성별(남성=1,녀성=0)-5.540。수시자균우동기진행간천자활검。이간천자활검병리결과위금표준,회제출FT치공작특정곡선,계산곡선하면적( AUC),평개기재만성을형간염간섬유화정도판단중적개치。결과간장병리섬유화분기위S0기4례,S1기59례,S2기41례,S3기31례,S4기13례。현저간섬유화85례,엄중간섬유화44례,조기간경화13례。148례환자적 FT 치위0.616±1.152,기중병리섬유화분기위S0、S1、S2、S3、S4기적 FT치분별위-0.326±0.378、-0.167±1.145、0.906±0.834、1.308±0.516、1.894±0.544,S0、S1、S2、S3、S4기적FT치량량비교,P균<0.05。 FT치여간장병리분기정정상관(r=0.629,P<0.01)。 FT치판단현저간섬유화、엄중간섬유화급조기간경화적AUC분별위0.831、0.889、0.945,cut-off치분별위0.403、0.756、1.385,진단준학솔분별위81.6%、85.5%、91.4%。결론 Fibro Test재만성을형간염간섬유화정도판단중유일정개치。
Objective Objective:To investigate value of FibroTest ( FT) for the evaluation of liver fibrosis in patients with chronic hepatitis B ( CHB) .Methods :Serum specimens from 148 patients with chronic hepatitis B were tested for five indicators including α2-macroglobulin (α2M), haptoglobin (HAP), γ-glutamyl peptidase (GGT), total bilirubin (BIL) and apolipoprotein aⅠ(Apo AⅠ) and calculated the FT values according to the FT model:FT=4.467 × [lgα2M (g/L)]-1.357 ×[lgHAP (g/L)] +1.017 ×[lgGGT (U/L)] +0.0281 ×[Age(?years)] +1.737 ×lg [TBIL(? mol/L)] -1.184 ×[Apo AⅠ(g/L)]+0.301 ×sex ( male =1 , female =0 ) -5.540.The subjects were given liver biopsy during the same period .With liver biopsy as the gold standard , the ROC curves were delineated for dif-ferent endpoints .The area under the curve ( AUC) was calculated to evaluate the determinate value for liver fibrosis in pa-tients with CHB.Results:There were 4 cases in the S0-stage (the pathological stage of liver fibrosis ), 59 cases in the S1-stage, 41cases in the S2-stage, 31cases in the S3 stage and 13 cases in the S4 stage.There were 85 cases of significant fi-brosis,4 cases of severe fibrosis, and 13 cases of early cirrhosis.The FT value of the 148 patients was 0.616 ±1.152, and the FT values of fibrosis pathologic stages from S 0 to S4 were-0.326 ±0.378,-0.167 ±1.145, 0.906 ±0.834, 1.308 ± 0.516, and 1.894 ±0.544 respectively.The FT values of any 2 of the5 Stages (S0-S4) were compared, and all the P val-ues were less than 0.05.There was a positive correlation between the value of FibroTest ?? and liver pathological stage, (r=0.629, p <0.01).For the group of significant fibrosis , severe fibrosis and early cirrhosis , the AUC values of FT were 0.831, 0.889 and 0.945, the cut-off values were 0.403, 0.756 and 1.385, and the diagnostic accuracy rates were 81. 6%, 85.5%and 91.4%respectively.Conclusion:Fibro test has a certain value for the evaluation of liver fibrosis in chro-nic hepatitis .