| Objective:To investigate the Fibro Scan-AST(FAST)score,Aspartate transaminase to platelet ratio index,Clinical diagnostic value of APRI and Fibrosis index on the 4 factor(FIB-4)in patients with chronic Hepatitis B virus(HBV)infection at different stages of liver fibrosis.Methods:A retrospective study was conducted to collect 168 patients with chronic HBV infection from the First Affiliated Hospital of Gannan Medical College and the Fifth People’s Hospital of Ganzhou City from October 2021 to November 2022 as research objects.Among them,28 patients underwent liver puncture pathological examination.According to the 2022 edition of the Chronic Hepatitis B Prevention and Treatment Guide,he would have 108 cases of chronic Hepatitis B(CHB)and 60 cases of hepatitis B cirrhosis(LC).Another 30 healthy subjects were collected as control group.Application of transient elastography(Fibro Scan FS)measurement in liver liver stiffness value of the object(Liverstiffnessmeasurement,LSM)and fat attenuation parameter(Controlledattenuationparameter,CAP),Blood routine and blood biochemical indexes were detected,and FAST score,APRI and FIB-4 values were calculated.The consistency of LSM fibrosis stage and liver biopsy pathological stage was analyzed.The correlation between FAST score,APRI,FIB-4 and LSM was analyzed.Draw the receiver-operating characteristic curve(Receiveroperatingcharacteristiccurve,ROC),clear each index in the liver fibrosis stage sensitivity,specificity and application area of ROC curve(Theareaunderthe ROCcurve,AUC)to evaluate the diagnostic efficacy of each index in different stages of liver fiber.Results:1.The clinical data of CHB group,LC group and healthy control group were compared between groups,and the results showed that there were statistically significant differences in age,ALT,AST,PLT,LSM and CAPamong the three groups(P<0.05).The results showed that there were statistically significant differences in age,ALT,AST,PLT and LSM among the three groups(P<0.05).There were statistically significant differences in CAP between CHB group and healthy control group,LC group and healthy control group(P<0.05),but there were no statistically significant differences between CHB group and LC group(P>0.05).2.The differences of FASTscore,APRI and FIB-4 in CHB group,LC group and healthy control group were statistically significant(P<0.05).Further pound-wise comparison suggested that the differences of FAST score,APRI and FIB-4 in the three groups were statistically significant(P<0.05).FAST score,APRI and FIB-4 values increased gradually in each group.3.The Kappa value of the consistency analysis between LSM fibrosis stage and liver fibrosis stage in pathological patients was 0.813,P<0.05,and the consistency was good.4.The results of correlation analysis showed that the correlation coefficient r and P between FAST score,APRI,FIB-4 and LSM fibrosis stage were 0.705,0.632 and 0.660,respectively,P<0.001,indicating that FAST score,APRI,FIB-4 had good correlation with LSM fibrosis stage,of which FAST score had the best correlation.5.The CHB group was further divided into two groups according to the LSM fibrosis stage: no obvious hepatic fibrosis(<F2)and significant hepatic fibrosis(≥F2).The area under the ROC curve(AUC)of FAST score,APRI and FIB-4 in the differential diagnosis of significant hepatic fibrosis(≥F2)in the CHB group was 0.850,0.778 and 0.787,respectively,and the sensitivity(Se)and specificity(Sp)were 0.893,0.762,0.869,0.750,0.750 and 0.625.The AUC of FAST score,APRI and FIB-4 in differential diagnosis of CHB and LC were0.827,0.882 and 0.906,respectively,and the sensitivity and specificity were 0.767,0.783,0.867,0.778,0.861 and 0.787,respectively.Conclusion:1.FAST score,APRI and FIB-4 have certain value in the diagnosis of liver fibrosis in patients with chronic HBVinfection at all stages.2.FAST score has the highest diagnostic efficiency for significant liver fibrosis(≥F2)in CHB,and has a certain auxiliary role in the dynamic evaluation of chronic hepatitis B patients;FIB-4 has the highest diagnostic efficiency for LC,and can be used for the early diagnosis of hepatitis B cirrhosis. |
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