HBsAg Levels Of ALT Normal To Assess The Diagnostic Value Of Chronic Hepatitis B Viral Hepatitis Liver Fibrosis Lesion

Object:To investigate the correlation between serum HBs Ag level and the severity of liver fibrosis in patients with chronic viral hepatitis B with normal ALT,and to find a specific cut-off value to predict the severity of liver fibrosis.Method:171 CHB patients with normal ALT and liver puncture were selected as the study subjects,including 67 cases（39.18%）in the mild fibrosis group and 104 cases（60.82%）in the moderate and severe fibrosis group.Demographic,laboratory tests,and liver perforation pathological results were collected.Univariate and multivariate Logistic regression models were used to screen for the factors influencing liver fibrosis,and receiver operating characteristic（ROC）curve was used to evaluate its diagnostic value.Result:The results of univariate and multivariate logistic regression analysis showed that age,serum HBs Ag,HBe Ag and PLT were independent influencing factors for significant liver fibrosis in CHB patients with normal ALT（p < 0.05）.Age was an independent risk factor（OR = 1.065,p < 0.05）,HBs Ag（OR=0.249,p<0.05）,HBe Ag（OR= 1.001,p < 0.05）and PLT（OR = 0.980,p<0.05）were independent protective factors.The area under the ROC curve（AUC）for predicting the occurrence of significant hepatic fibrosis in CHB patients with normal ALT was 0.709（95 %CI:0.633–0.786,p<0.001）,and the optimal critical value was≥38.The area under the ROC curve（AUC）of serum HBs Ag was 0.244（95 % CI : 0.172-0.316,p < 0.001）,and HBs Ag ≤ 3.72 log10 IU / ml was the best cut-off value.The area under the ROC curve（AUC）of serum HBe Ag was 0.312（95 % CI : 0.231-0.392,p < 0.001）,and HBe Ag ≤ 876.85 S / CO was the best critical value.The area under the ROC curve（AUC）of PLT was 0.287（95 % CI : 0.211 0.362,p < 0.001）,and PLT ≤ 153.5 × 10 9 / L was the optimal cut-off value.The accuracy and Yordon index of the above indicators for predicting liver fibrosis were 90%,75%,39%,97% and 0.37,-0.41,-0.33,-0.33,respectively.Conclusions:Alt-normal CHB patients do not mean that there is no fibrosis,age,HBs Ag,HBe Ag,PLT are independent influential factors for the occurrence of significant liver fibrosis in ALt-normal CHB patients.HBs Ag can accurately diagnose the severity of liver fibrosis in liver tissue.