The Clinical Value Of Fibroscan Combined With Serological Model In Hepatitis B Cirrhosis

Objective:(1)The relationship and correlation between Fibroscan,FIB-4,APRI,AAR,S index and different stages of hepatitis B cirrhosis were analyzed.(2)Evaluate the diagnostic value of Fibroscan,FIB-4,APRI,AAR and S index in the diagnosis of hepatitis B cirrhosis complications.Methods:A total of 149 patients who were diagnosed with hepatitis B cirrhosis and received Fibroscan examination in the First Hospital of Jilin University from September 2014 to September 2017 were enrolled in the study.Collected the age,sexuality,Liver stiffness measurement(LSM),serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),r-glutamyl transferase(GGT),platelet(PLT)and other clinical data of the patients.Then calculated the numerical value of LSM,FIB-4,APRI,AAR,S index according to the formula;Compare LSM,FIB-4,APRI;AAR,S index in different stages of hepatitis B cirrhosis;Analysed the correlation between Fibroscan and FIB-4,APRI,AAR,S index;Draw the ROC curve and evaluate Fibroscan,FIB-4,APRI,AAR S index in the diagnosis and prediction of hepatitis B cirrhosis complications.Results:(1)The difference of The LSM,FIB-4,APRI,AAR and S index between patients with compensted cirrhosis or decompensted cirrhosis were compared.The LSM value,,FIB-4index,APRI,AAR and S index in decompensated stage were higher than in compensted period,and there was statistically significant difference(P<0.001)?(2)The LSM,FIB-4,APRI,AAR,S index were different in patients with different liverfunction;The pairwise comparison among the three groups,LSM,AAR,FIB-4,APRI,S index had the statistically significant difference between Child-Pugh A and Child-Pugh B(P<0.05).There was a statistically significant difference in LSM,APRI,FIB-4,between Child-Pugh B and Child-Pugh C(P<0.05),but the difference of AAR and S index was no statistically significant between the two groups(P>0.05).LSM,AAR,FIB-4,APRI,S index had the statistically significant difference between Child-Pugh A and Child-Pugh C(P<0.05)..(3)The LSM,FIB-4,APRI,AAR and S index of non complication group and complications group of hepatitis B cirrhosis patients were compared.The LSM,FIB-4,APRI,AAR and S index of complications group was significantly higher than those of non complication group(P<0.001).(4)The correlation analysis showed that FIB-4,APRI,AAR and S index had significant positive correlation with Fibroscan,and the strongest correlation between Fibroscan and FIB-4 was 0.453(5)The area under ROC curve(AUC)of Fibroscan,FIB-4,APRI,AAR,S index for separately diagnosis of liver fibrosis complications were 0.860,0.760,0.722,0.705,0.751,0.7<AUC<0.9.The diagnostic value of the five models are moderate.The AUC value of Fibroscan for the diagnosis of hepatitis B cirrhosis complications was 0.860,which had the highest diagnostic value than anyone of APRI,FIB-4,AAR,S index.Conclusion:For hepatitis B cirrhosis,the more severe the cirrhosis,the higher the value of Fibro Scan and APRI,FIB-4,AAR and S index is.In clinical work,we should pay attention to monitoring the level of LSM and APRI,FIB-4,AAR and S index in patients with cirrhosis,which is of important clinical guiding significance for the severity of liver damage,the curative effect and prognosis of liver cirrhosis.In addition,Fibroscan APRI,FIB-4,AAR,S index can predict the complications of hepatitis B cirrhosis.