The Diagnostic Value Of Serum Cholinesterase、Prealbumin And Hepatitis B Core Antibody In HBV-associated Liver Fibrosis

Objective: To evaluate the value of CHE,PAB and HBcAb in the diagnosis of significant liver fibrosis(F≥2)by observing the changes of serum CHE,PAB and HBcAb levels in patients with chronic HBV infection and their correlation with liver tissue fibrosis.Methods: 1.According to the inclusion criteria,to collect patients with chronic HBV infection who have done liver biopsy in the First Affiliated Hospital of Hainan Medical college between January 2016 and December 2019.The total selected patients are 86 cases.To collect the clinic information,such as gender,age,blood routine,liver function,hepatitis B marker,and the pathological results of liver biopsy.2.To calculated the values of APRI and FIB-4 index by the blood routine,liver function and age results.3.To divide the patients into HBe Ag-positive and HBe Ag-negative groups.To compare the specificity,sensitivity and positive predictive value of CHE,PAB,CHE /PAB and HBcAb alone in the diagnosis of significant liver fibrosis in each group,and to compare the diagnostic value of CHE,PAB and CHE /PAB combined with HBcAb respectively in the diagnosis of significant liver fibrosis.Results: 1.With the improvement of liver fibrosis stage,PAB decreased gradually while CHE/PAB increased gradually(P<0.05);2.In the single diagnosis of significant liver fibrosis,CHE had the highest specificity(94.4%),while HBcAb was the highest sensitivity(96%).3.In the combined diagnosis of significant liver fibrosis,CHE/PAB combined with HBcAb had good specificity and sensitivity,and was superior to the recommended APRI index and FIB-4 index in the guidelines.The area under the curve was 0.819(95%CI: 0.729-0.909),the positive predictive value was 86.842%,the negative predictive value was 64.583%,and the accuracy was 74.419%.4.CHE/PAB combined with HBcAb has high diagnostic value in the diagnosis of significant liver fibrosis in HBe Ag-positive and HBe Ag-negative,and its specificity and sensitivity are better than those of single detection indexes and other combined detection indexes.Conclusion: CHE/PAB combined with HBcAb can improve the diagnostic accuracy of significant liver fibrosis,which provides a new diagnostic concept for clinical work.