| Object to investigate the diagnosis value of Fibro Index and APRI and its consociation in hepatitis B induced hepatic fibrosis,To develop noninvasive method for detecting the severity and activity of the patients with hepatitis B induced hepatic fibrosis.Methods1.Liver biopsy and blood tests were performed a total of 180 Patients with Chronic B type hepatitis who was once in the first hospital affiliated to Hunan College of Traditional Chinese Medicine,The value of serology in evaluating liver fibrosis degree was analyzed and studied.2.the integral quantity was obtained by two independent model respectively,then it will be analyzed the diagnose value of liver fibrosis between every model and serum markers,secondly,the same to between the united model and two independent model,on this way the better measure to diagnose the hepatitis B-related fibrosis can be found.3.Statistical analysis was performed by SPSS software version 12.0 (SPSS Inc,Chicago,IL). Results1.Liver fibrosis stage was correlated to inflammation degree with a Coefficient of 0.490.2.Platelet count(PLT),GammaGltranspeptidase(GGT), Hyaluromic Acid(HA),typeⅢProcollagen petide(PCⅢ),Alanine aminotransferasa(ALT) were correlated with liver fibrosis stage,but most serum markers were not significantly different between contiguous fibrosis stages.3.Receiver operating characteristic(ROC) curve analysis revealed that HA had higher diagnostic value than other three serum fibrosis markers in identifying liver fibrosis stages(Area under the ROC curve (AUC):HA＞PCⅢ＞LN) and LN had no significant diagnostic value(P＞0.05).At the cut-off value of each marker,the diagnostic sensitivity was 41.3-86.1%,specificity was 54.5%-87.7%,and accuracy was 60.4%-74.1%.Combination of markers did not increase diagnostic value than any other single marker.Although the prevalence of markers above upper limit of normal increased with the progression of fiver fibrosis, there was no significant difference in prevalence of abnormal marker between stages of liver fibrosis.4.Comparing the diagnosis value between independent model and any single serum mark each,the result was that the diagnosis efficient of each model was better than any latter. 5.The diagnosis of liver fibrosis is according to the critical value of Fibro Index 2.2 and APRI 1.5,The diagnosis of early cirrhosis is according to the critical value of Fibro Index 5.4 and APRI 2.0,The diagnosis was analyzed between united model and two independent models by the ROC curve,it can be concluded that the united model is better than each independent model in the diagnosis of fibrosis.Conclusion1.Liver fibrosis and inflammation are associated with each other, but there are some deviations during the progression of chronic liver disease.2.Some serum markers may reflect the change of liver fibrosis,but none of these alone has been proven to accurately distinguish between individual fibrosis stages.Serum fibrosis markers are useful for staging liver fibrosis,Although HA has the best diagnostic potential among four fibrosis markers,its sensitivity,specificity and accuracy are from optimal.3.The united model has fairly well diagnostic value in differentiating the severity of liver fibrosis,and is superior to Fibro Index and APRI,meanwhile the diagnosis value of both independent models are better than other single serum markers.According to their thresholds,the stages of hepatitis B-related fibrosis can be identified.In a word,according to our research,the stages of hepatitis B-related fibrosis may be evaluated by The united model constituted with Fibro Index and APRI,which can be recommended as an alternative to liver biopsy for the assessment of liver fibrosis. |
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