The Study Of Noninvasive Diagnosis Of Liver Fibrosis And Cirrhosis In HBV Infection

Objective:Using receiver operating characteristic (ROC) curve to evaluate the relation among a single serum markers, Age, APRI, S index and liver function in hepatitis B liver fibrosis and cirrhosis patients, and to establish the diagnostic formula and explore its clinical significance..Methods:139 cases with complete clinical data and confirmed to be as liver fibrosis or cirrhosis by pathological findings were retrospectively analyzed,and 129 cases were liver cirrhosis. The latter according to Child-Pugh classification of liver function and clinical data of patients, divided into 58 patients with compensated cirrhosis group,71 patients with decompensated cirrhosis group.Collection of all patients who admitted to hospital on the second day of the fasting biochemical investigations, blood coagulation and HBV laboratory test results, using ROC curve to evaluate the sensitivity of each index,specificity and the area under the ROC curve (AUC), all indicators had a value in patients of liver cirrhosis diagnosis, and compared the diagnostic value. And application of statistical methods to establish the diagnosis formula.Results:ALB is the best indicator with the highest specificity and sensitivity were 64.3%, 89.7, when the outcome is 30.6, AUC was 0.820 (95% CI:0.742-0.882, P<0.01). AST, ALT,AST/ALT,GLB,ALP,GGT,BUN,Crea,Glu,LDH,FIB,WBC,L%,N%,TP,CK,APTT not ap propriate for evaluation between compensated cirrhosis and decompensat-ed cirrhosis (P>0. 05).The diagnostic value of liver function according to the diagnostic ac-curacy were LD L,Age,PLT, HDL,Hb, APRI,TG,RBC,CHOL,PT,ALB/GLB,IBil,DBil,TBil,ALB(P<0.05) fro m low to high.The corresponding AUC were 0.61,0.634,0.636,0.644,0.665,0.668,0.685,0.68 8,0.695,0.695,0.736,0.756,0.783,0.785,0.82.To develop the discriminant equation:Z=0. 096ALB-0.017A/G +0.275 CHOL-0.044PT +0.104 RBC-3.073.Conclusion:The indicators between liver fibrosis and compensated cirrhosis groups were not statistically different except AST.LDL,Age,PLT,HDL,Hb,APRI,TG,RBC,CHOL,PT,S ind ex,ALB/GLB,IBil,DBil, TBil,ALB between compensated cirrhosis and decompensated cirrh-osis patients has statistically significant difference.TBil, DBil, TBil evaluate liver function of the diagnostic accurac-y in cirrhosis patients like ALB(P> 0.05).Other indicators such as Age,S index,ALB/GLB, HDL,CHOL,TG,Hb,RBC,PLT,PT,APRI,LDL less than the diag-nostic accuracy of ALB,but all have a certain diagnosis.To build a diagnostic algorithm and the accuracy is above 80% between compensated cirrhosis and decompensated cirrhor-sis.