| Objective: To explore the evaluation value of liver transient elastography combined with aspartate aminotransferase/platelet ratio index(APRI score),4-factor model(FIB-4)and age-platelet index model(Ap index)on hepatitis B liver fibrosis.Methods: Using retrospective research methods,a total of 157 patients were selected from the First People's Hospital of Huaihua City,Jishou University,who were diagnosed with chronic viral hepatitis B in the Infectious Disease Center from 2016 to 2019.All patients were divided into three groups: S0-S1,S2-S3,and S4 according to the pathological results of liver biopsy.They respectively indicated no obvious liver fibrosis group,obvious liver fibrosis group and early liver cirrhosis group.Collect blood biochemical related indicators and general information of the patients in the group,and then calculate the specific values of APRI score,FIB-4,AP index through mathematical formula of non-invasive model,and record the liver hardness measurement value measured by Fibro Touch.Analyze the above non-invasive diagnostic models(APRI score,FIB-4,AP index)and the differences between Fibro Touch and different stages of liver biopsy(S).Correlation between Fibro Touch and three non-invasive diagnostic models APRI score,FIB-4,Ap index and pathological results of liver biopsy were calculated.Analysis of early warning value of non-invasive indicators combined with hepatitis B liver fibrosis(S?2).Then draw the receiver operating characteristic(ROC)curve,and calculate the best prediction value,sensitivity and specificity.Results: 1.General information: This retrospective study collected 157 eligible patients after screening.The gender frequency and composition ratio were 75 males(47.77%)and 82 females(52.23%)respectively.And standard deviation(42.33±10.49);pathological fibrosis results of patients S0(N=13,composition ratio 8.28%),S1(N=69,composition ratio 43.95%),S2(N=42,composition ratio 26.75%),S3(N=19,composition ratio 12.10%),S4(N=14,composition ratio 8.92%);LSM,APRI score,FIB-4,and AP index are expressed by median and interquartile range,respectively,10.20(7.80 to 13.30),0.52(0.36 to 0.82),1.44(0.91 to 1.98),and 5.00(3.00 to 6.00).2.The LSM,APRI score,FIB-4,and AP index showed significant differences among CHB patients in the S0-S1 group,S2-S3 group,and S4 group,with statistical significance(P<0.05).3.APRI score,FIB-4,AP index and Fibro Touch four non-invasive diagnostic methods have good consistency with liver biopsy results(P<0.05),and Fibro Touch is the best,with Spearmancorrelation coefficients(r)of 0.397,0.377,0.269,0.662(P<0.05).4.Based on the results of liver pathology,the patients were divided into non-obvious liver fibrosis group(S0-S1)and liver fibrosis group(S?2).Binary multivariate logistic regression was performed for four non-invasive diagnosis methods of liver fibrosis The analysis shows that the APRI score,FIB-4,AP index and Fibro Touch have certain predictive value for early liver fibrosis(P<0.05),and their odds ratios(OR)are 3.122,1.961,1.276,and 1.173,respectively;The four non-invasive diagnostic methods are parameter fitting binary logistic regression equations,and the joint warning equation Logit(P)=-1.502 + 1.139×(APRI)+ 0.674×(FIB-4)+ 0.244×(AP index)+ 0.160×(Fibro Touch).The ROC curve analysis showed that the combined detection of four non-invasive diagnostic methods has the greatest early predictive value for liver fibrosis(S?2),and Fibro Touch has the best performance.The difference is better than the AP index.The area under the curve(AUC)of the four non-invasive diagnostic methods is the largest,which is 0.871,the Jordan index is 0.690,the diagnostic threshold is 0.456,and the sensitivity and specificity are 0.910,0.780,and 95% confidence interval 0.817?0.926.Conclusion: Fibro Touch combined with APRI score,FIB-4,and AP index are of higher value for the evaluation of hepatitis B liver fibrosis and deserve further promotion. |
PDF Full Text Request