Combined Serum Fibrosis Markers And Portal Perfusion Index To Evaluate Chronic Hepatitis B And Cirrhosis

Object:To explore the application value of combining serum fibrosis markers and portal perfusion index (PPI) in evaluating disease severity of chronic hepatitis B (CHB) and in predicting functional reserve of cirrhosis.Methods:Seventy-two patients of hepatitis B, including 29 cases with chronic hepatitis B(mild in 19 cases, moderate in 10 cases) and 43 cases of cirrhosis (Compensated in 13 cases, decompensated in 30 cases) were analyzed and the Child-Pugh scores were calculated in patients with cirrhosis retrospectively. Twenty healthy volunteers were selected randomly as normal controls. The serum fibrosis markers (PIIINP, CIV, LN, HA) were measured respectively and the PPI was obtained by liver radionuclide perfusion imaging. Using PASW Statics 18.0 software, the parameters of each group were analyzed in One-way ANOVA, and the relation of parameters and Child-Pugh score was investigated with Pearson correlation. Results:1. The comparison of serum fibrosis markers and PPI between normal controls, CHB and cirrhosis patients:The means of HA in moderate CHB and Compensated cirrhosis patients were higher than those in normal controls and mild CHB patients (P<0.05), but was lower than that in decompensated patients (P<0.01). In all groups of CHB and cirrhosis, the means of PIIIP were higher than that in normal controls (P<0.05), and moderate CHB was the highest (P<0.01). Both the means of CIV in mild CHB and Compensated cirrhosis patients and the means of LN in moderate CHB patients have no significant difference with normal controls (P>0.05). The means of PPI in moderate CHB, Compensated and decompensated cirrhosis patients were lower than those in normal controls and mild CHB patients, and gradually decreased with disease progression (P<0.05).2. The relationship between serum fibrosis markers and PPI and functional reserve in cirrhosis patients:The level of PIIIP (r=0.419) and HA (r=0.565) correlated positively to the Child-Pugh scores (P<0.01), but the value of PPI correlated negatively to the Child-Pugh scores (r=-0.383, P<0.05).Conclusion:All HA, PIIIP and PPI may assess disease severity in patients with CHB and/or predict functional reserve in patients with cirrhosis effectively, in which HA focuses on the prediction of functional reserve, while PPI focuses on the evaluation of disease severity. In short, the combination of HA, PIIIP and PPI can obtain more comprehensive information about disease severity and functional reserves, and has important reference value in diagnosis and treatment of CHB and cirrhosis.