| Objective:To analyze the relationship and correlation between the aspartate aminotransferase to platelet ratio index(APRI),FIB-4,Fornsindex,Sindex,Fibroscan with liver fibrosis of chronic hepatitis B,and their separately or jointly diagnostic value for liver fibrosis of chronic hepatitis B.To provide some clinical evidence for noninvasive diagnosis in liver fibrosis of chronic hepatitis B.Methods: To collect outpatients and inpatients with chronic hepatitis B who have done the liver biopsy in the General Hospital of Ningxia Medical University between 2009 and 2015,using retrospective analysis method.The total selected patients are 91 cases.According to the degree of liver fibrosis confirmed by liver biopsy, divided the selected patients into three groups, including 32 cases in the no liver fibrosis group(=S0);30 cases in the mild liver fibrosis group(<S2),29 cases in the significant liver fibrosis group(?S2).To collect clinical data and the peripheral venous blood to examine the serum markers of albumin(ALB),?-glutamyltranspeptidase(GGT),alanine aminotransferase(ALT), aspartate aminotransferase(AST), total cholesterol(Tch), and platelet(PLT). According to the formula, calculated the values of APRI,FIB-4, Fornsindex, Sindex and examined Fibroscan simultaneously. To analysis therelationship and correlation of APRI,FIB-4,Fornsindex,Sindex,Fibroscan with liver fibrosis of chronic hepatitis B. To evaluate the separately or jointly diagnostic value of APRI,FIB-4, Fornsindex, Sindex, Fibroscan in liver fibrosis of chronic hepatitis B,using sensitivity, specificity and area under the ROC curve(AUC).Results:(1)Compare to the clinical data among the no liver fibrosis group, the mild fibrosis group,the significant fibrosis group,The results show that the difference of Age,ALB,AST,ALT,PLT has statistically significant among the three groups(F values are 3.552,4.035,4.374,5.992,P<0.05).The pairwise comparison by the Dunnett-ttest suggest Age,ALB,AST,ALT,PLT has the statistically significant difference between the no liver fibrosis group and the liver fibrosis group(the mild liver fibrosis group, the significant liver fibrosis group)(P<0.05),but the difference is no statistically significant between the mild liver fibrosis group and the significant liver fibrosis group(P>0.05).(2)Compare to APRI,FIB-4,Fornsindex, Sindex,Fibroscan has statistically significant among the three groups(F values are 4.579,5.728,10.501,14.118,30.039,P<0.05).Then pairwise comparison suggest APRI,FIB-4,Fornsindex,Sindex,Fibroscan has the statistically significant difference between the no liver fibrosis group and the liver fibrosis group(the mild liver fibrosis group, the significant liver fibrosis group)(P<0.05), but the difference of APRI,FIB-4,Fornsindex,Sindex is no statistically significant between the mild liver fibrosis group and the significant liver fibrosis group(P>0.05),while the difference of Fibroscan between the mild liver fibrosis group and the significant liver fibrosis group still has statistically significant(P<0.05).(2)APRI,FIB-4,Fornsindex, Sindex,Fibroscan increased gradually among the no liver fibrosis group, the mild fibrosis group, the significant fibrosis group.The correlation analysis sho ws that APRI,FIB-4,Fornsindex,Sindex,Fibroscan have significant positive correlation with the degree of liver fibrosis(The correlation coefficient r are 0.499?0.498?0.402?0.395? 0.739, P <0.05).(3)The area under ROC curve(AUC) of APRI,FIB-4, Fornsindex,Sindex for separately diagnosis of liver fibrosis are 0.786(95%CI 0.679~0.892),0.818(95%CI 0.717~0.918),0.770(95%CI 0.661~0.880),0.718(95%CI 0.599~0.837),0.7<AUC<0.9,The diagnostic value of the four models are moderate. AUC of Fibroscan for separately diagnosis of liver fibrosis is 0.919(95%CI 0.864~0.974). It have the highest diagnostic value than anyone of the APRI,FIB-4, Fornsindex,Sindex.(3)The AUC values can be increased to 0.922(95%CI 0.868~0.976),0.931(95%CI 0.881~0.981),0.926(95%CI 0.873~0.979),0.918(95%CI 0.862~0.974) after APRI,FIB-4,Fornsindex,Sindex joint with Fibroscan respectively,the diagnostic values of liver fibrosis have been significantly improved. Further study showes that the diagnostic value of the AUC value can be increased to 0.927(95%CI0.875~0.979), if Fibroscan is joined with APRI,FIB-4,Fornsindex,Sindex all together.Conclusion(1)APRI, FIB-4,Fornsindex,Sindex,Fibroscan respectively has a positive correlation with the degree of liver fibrosis(S).(2)The diagnostic accuracy for liver fibrosis can be increased after Fibroscan is joined with APRI,FIB-4,Fornsindex,Sindex all together,which has early diagnosis value of liver fibrosis approach to pathology diagnostic value. |
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