【摘要】 目的研究慢性乙型肝炎(CHB)患者AST/血小板(PLT)比值(APRI)及ALT/PLT比值(BPRI)与肝组织病理改变的关系。方法收集2004年2月-2014年2月于柳州市人民医院行肝活组织检查的CHB患者167例,检测患者的血常规及肝功能,将APRI、BPRI与肝组织病理进行分析。计量资料组间比较采用Mann-Whitney U检验,分析评价采用受试者工作特征(ROC)曲线法。结果在肝组织病理炎症分级G0、G1、G2、G3、G4各组中,APRI进行比较,G1与G2、G3差异均具有统计学意义(P值均<0.05);G0~1组与G2~4组的APRI比较差异有统计学意义(P<0.05)。各组BPRI进行比较,G0与G4、G1与G2差异均有统计学意义(P值均<0.05)。G0~1与G2~4进行比较,BPRI差异有统计学意义(P<0.05)。在S0、S1、S2、S3、S4各组中,APRI、BPRI两两比较,S2与S3差异均有统计学意义(P值均<0.05)。APRI、BPRI预测肝组织炎症G2~4的ROC曲线下面积分别为0.748、0.736(95%可信区间分别为0.669~0.827、0.653~0.819,P值均<0.000 1),APRI、BPRI预测肝组织炎症G2~4级的最佳截断值分别为0.601、0.630,灵敏度分别63.6%、82.7%,特异度分别为74.5%、59.6%,约登指数分别为39.0%、42.4%。结论 APRI、BPRI可作为预测CHB患者肝组织炎症活动度的指标,但APRI、BPRI可能无法预测CHB患者肝纤维化分期。更多还原

【Abstract】 Objective To investigate the values of aspartate aminotransferase to platelet ratio index( APRI) and alanine aminotransferase to platelet ratio index( BPRI) for the prediction of pathological changes in liver tissue in patients with chronic hepatitis B( CHB). Methods A total of 167 CHB patients who visited the People’s Hospital of Liuzhou from February 2004 to February 2014 were collected. Liver biopsy,routine blood test,and liver function test were performed,and then the correlation between APRI / BPRI and liver pathology was analyzed.The Mann- Whitney U test was applied for comparison of continuous data between groups,and the receiver operating characteristic( ROC)curve was used to evaluate the predictive values of APRI and BPRI for liver pathological staging. Results APRI was compared between G0,G1,G2,G3,and G4 groups with different liver inflammation grades,and the G1 group had a significantly different APRI value than the G2 and G3 groups( both P < 0. 05); the G0- 1 group had a significantly different APRI value than the G2- 4 group( P < 0. 05). BPRI was also compared between these groups,and it differed significantly between the G0 group and G4 group and between the G1 group and G2 group( both P < 0. 05); the G0- 1 group had a significantly different BPRI value than the G2- 4 group( P < 0. 05). APRI and BPRI were compared between each two of S0,S1,S2,S3,and S4 groups,and they showed significant differences between the S2 and S3 groups( P <0. 05). The areas under the ROC curve of APRI and BPRI for predicting liver inflammation G2- 4 were 0. 748 and 0. 736,respectively( 95% CI: 0. 669- 0. 827 and 0. 653- 0. 819,respectively; both P < 0. 000 1); the optimal cut- off values for APRI and BPRI to predict liver inflammation G2- 4 were 0. 601 and 0. 630,respectively,with sensitivity,specificity,and Youden index of 63. 6% /82. 7%,74. 5% /59. 6%,and 39. 0% /42. 4%,respectively. Conclusion APRI and BPRI can be used to predict liver inflammatory activity in CHB patients.更多还原