AIM To investigate the value of the gamma-glutamyltraspeptidase(GGT)-to-platelet(PLT) ratio(GPR) in the diagnosis of hepatic fibrosis in patients with chronic hepatitis B(CHB). METHODS We included 390 untreated CHB pa...AIM To investigate the value of the gamma-glutamyltraspeptidase(GGT)-to-platelet(PLT) ratio(GPR) in the diagnosis of hepatic fibrosis in patients with chronic hepatitis B(CHB). METHODS We included 390 untreated CHB patients in this study. The GPR, aspartate aminotransferase(AST)-to-PLT ratio index(APRI), and fibrosis-4(FIB-4) of all patients were analysed to determine if these parameter were correlated with age, gender, medical history, liver function [total bilirubin(TBil), alanine aminotransferase(ALT), and AST], GGT, PLT count, or hepatic fibrosis stage. The GPR, APRI, and FIB-4, as well as the combination of the GPR and APRI or the GPR and FIB-4 were assessed in different cirrhosis stages using receiver operating characteristic(ROC) curve analysis to evaluate their value in diagnosing hepatic fibrosis in CHB patients. RESULTS The GPR, APRI, and FIB-4 were not correlated withCHB patients' age, gender, or disease duration(P > 0.05), but all of these parameters were positively correlated with serum ALT, AST, GGT, and PLT count(P < 0.01). Additionally, the GPR, APRI, and FIB-4 were positively correlated with hepatic fibrosis(P < 0.01); the areas under the ROC curve for the GPR in F1, F2, F3, and F4 stages were 0.723, 0.741, 0.826, and 0.833, respectively, which were significantly higher than the respective values for the FIB-4 and APRI(F1: 0.581, 0.612; F2: 0.706, 0.711; F3: 0.73, 0.751; and F4: 0.799, 0.778). The respective diagnostic cut-off points for each stage were 0.402, 0.448, 0.548, and 0.833, respectively. The diagnostic sensitivity and specificity were, respectively, 88.8% and 87.5% in F1, 72.7% and 89.7% in F2, 81.3% and 98.6% in F3, and 80% and 97.4% in F4 when the GPR and APRI were connected in parallel; 86.6% and 90.2%, 78.4% and 96%, 78.6% and 97.4%, and 73.2% and 97.9%, respectively, when the GPR and APRI were connected in series; 80.2% and 89%, 65% and 89%, 70.3% and 98.5%, and 78.8% and 96.8%, respectively, when the GPR and FIB-4 were connected in parallel; and 83.6% and 87.9%, 76.8% and 96.6%, 72.7% and 98%, and 74.4% and 97.7%, respectively, when the GPR and FIB-4 were connected in series.CONCLUSION The GPR, as a serum diagnostic index of liver fibrosis, is more accurate, sensitive, and easy to use than the FIB-4 and APRI, and the GPR can significantly improve the sensitivity and specificity of hepatic fibrosis diagnosis in CHB when combined with the FIB-4 or APRI.展开更多
The FIB-4 index is a simple and noninvasive algorithm consisting to evaluate liver fibrosis in chronic HCV infection. Aim: To evaluate the utility of FIB-4 index as a noninvasive marker to assess liver fibrosis in chr...The FIB-4 index is a simple and noninvasive algorithm consisting to evaluate liver fibrosis in chronic HCV infection. Aim: To evaluate the utility of FIB-4 index as a noninvasive marker to assess liver fibrosis in chronic HCV infection in comparison to transient elastography. Patients and Methods: We studied 30 patients having chronic HCV infection based on clinical features, laboratory tests, diagnostics images, Fibroscan and FIB-4 score. According to the results of Fibroscan, the 30 patients were classified into two groups in order to obtain a cutoff value to exclude patient with significant fibrosis: group Ia: 7 patients with no or mild liver fibrosis (F0-F1) and group Ib: 23 pa-tients with significant fibrosis or cirrhosis (F2-F3-F4). Group IIa: 17 patients with no or significant fibrosis (F0-F1-F2-F3) and group IIb (F4): 13 patients with cirrhosis (F4). Results: The mean of FIB-4 index increased with the increase of the fibrosis score. FIB-4 index proved to be sensitive and specific in differentiation between patients with no or mild fibrosis (F0-F1) and patients with significant fibrosis or cirrhosis (F2-F3-F4) with the best cutoff value at 1.61. It also proved to be sensitive and specific in differentiation between patients with no or significant fibrosis (F0-F1-F2-F3) and patients with cirrhosis (F4) with cutoff value at 1.88. Conclusion: The FIB-4 index enabled the correct identification of extreme types of fibrosis. Using these cutoffs (1.61 - 1.88), 87% of patients fell outside these ranges and could thus avoid liverbiopsy with an overall accuracy of 70%.展开更多
目的探讨FIB-4(fibrosis index based on the 4 factor)指数对慢性乙型肝炎患者肝纤维化诊断价值。方法检测86例慢性乙肝患者血清ALT(谷丙转氨酶)、AST(谷草转氨酶)、PLT(血小板)等指标,根据病理肝纤维化分期设定两个判定点,分别为显著...目的探讨FIB-4(fibrosis index based on the 4 factor)指数对慢性乙型肝炎患者肝纤维化诊断价值。方法检测86例慢性乙肝患者血清ALT(谷丙转氨酶)、AST(谷草转氨酶)、PLT(血小板)等指标,根据病理肝纤维化分期设定两个判定点,分别为显著纤维化(≥S2级)和肝硬化(S4级),采用FIB-4指数加以评分,以肝组织病理学检查作对比,根据受试者工作特征曲线(AU-ROCs)评价FIB-4对于肝纤维化的诊断价值。结果FIB-4指数采用AUROCs加以评价,显示FIB-4≥S2级(显著纤维化)AUC曲线下面积为0.813,以1.56分值为界值,诊断显著肝纤维化敏感性、特异性、PPV和NPV分别达到86.21%、71.43%、86.2%和71.4%。S4级(肝硬化)AUC曲线下面积为0.802,以2.2分值为界值,诊断肝硬化敏感性、特异性、PPV和NPV分别达到87.5%、67.14%、37.8%和95.9%。结论FIB-4指数是一种简单易行、预测结果可靠的非侵入诊断方法,在一定程度上可替代肝活检。展开更多
目的系统评价FIB-4预测慢性肝病患者出现肝细胞癌的价值。方法检索PubMed、Web of Science、中国知网和万方数据库中有关FIB-4预测慢性肝病患者肝细胞癌风险的文献,并根据纳入和排除标准筛选,利用RevMan 5.3软件进行统计分析。结果共纳...目的系统评价FIB-4预测慢性肝病患者出现肝细胞癌的价值。方法检索PubMed、Web of Science、中国知网和万方数据库中有关FIB-4预测慢性肝病患者肝细胞癌风险的文献,并根据纳入和排除标准筛选,利用RevMan 5.3软件进行统计分析。结果共纳入文献35篇,包含肝细胞癌患者94569例。Meta分析结果显示:慢性肝病患者基线高FIB-4(HR=1.57,95%CI:1.41-1.75,P<0.01)及抗病毒治疗后高FIB-4(HR=2.40,95%CI:1.74-3.32,P<0.01)与慢性乙肝或慢性丙肝患者的高肝细胞癌风险有关。结论FIB-4可预测慢性肝病患者的肝细胞癌风险。展开更多
目的探讨NT-proBNP(N-terminal pronatriuretic peptide,NT-proBNP)、Hcy(Homocysteine,Hcy)、D-二聚体(D-dimer,D-D)和FIB(forward information data base,FIB)检测在慢性心力衰竭中的临床价值。方法选取2016年1月~2017年1月在我院住...目的探讨NT-proBNP(N-terminal pronatriuretic peptide,NT-proBNP)、Hcy(Homocysteine,Hcy)、D-二聚体(D-dimer,D-D)和FIB(forward information data base,FIB)检测在慢性心力衰竭中的临床价值。方法选取2016年1月~2017年1月在我院住院治疗的慢性心力衰竭患者50例,同期选择在本院体检中心接受健康体检的健康人50例作为对照组,比较两组的NT-proBNP、Hcy、D-二聚体和FIB的水平,以及不同心功能分级慢性心力衰竭患者的NT-proBNP、Hcy、D-二聚体和FIB水平。结果疾病组患者的NT-proBNP、Hcy、D-D和FIB水平显著高于对照组,差异具有统计学意义(P<0.05)。Ⅳ级组患者的NT-proBNP、Hcy、D-D和FIB水平显著高于Ⅱ级、Ⅲ级组,差异具有统计学意义(P<0.05)。随着心功能分级的增加,NT-proBNP、Hcy、D-二聚体和FIB水平逐渐增加。结论 NT-proBNP、Hcy、D-二聚体和FIB各项指标的检测对于慢性心力衰竭的诊断具有临床价值,且可以作为评价慢性心力衰竭严重程度的重要参考指标。展开更多
基金Supported by National Natural Science Foundation of China,No.81460301 and No.81760363Key Project of Natural Science Foundation of Ningxia,No.NZ15134
文摘AIM To investigate the value of the gamma-glutamyltraspeptidase(GGT)-to-platelet(PLT) ratio(GPR) in the diagnosis of hepatic fibrosis in patients with chronic hepatitis B(CHB). METHODS We included 390 untreated CHB patients in this study. The GPR, aspartate aminotransferase(AST)-to-PLT ratio index(APRI), and fibrosis-4(FIB-4) of all patients were analysed to determine if these parameter were correlated with age, gender, medical history, liver function [total bilirubin(TBil), alanine aminotransferase(ALT), and AST], GGT, PLT count, or hepatic fibrosis stage. The GPR, APRI, and FIB-4, as well as the combination of the GPR and APRI or the GPR and FIB-4 were assessed in different cirrhosis stages using receiver operating characteristic(ROC) curve analysis to evaluate their value in diagnosing hepatic fibrosis in CHB patients. RESULTS The GPR, APRI, and FIB-4 were not correlated withCHB patients' age, gender, or disease duration(P > 0.05), but all of these parameters were positively correlated with serum ALT, AST, GGT, and PLT count(P < 0.01). Additionally, the GPR, APRI, and FIB-4 were positively correlated with hepatic fibrosis(P < 0.01); the areas under the ROC curve for the GPR in F1, F2, F3, and F4 stages were 0.723, 0.741, 0.826, and 0.833, respectively, which were significantly higher than the respective values for the FIB-4 and APRI(F1: 0.581, 0.612; F2: 0.706, 0.711; F3: 0.73, 0.751; and F4: 0.799, 0.778). The respective diagnostic cut-off points for each stage were 0.402, 0.448, 0.548, and 0.833, respectively. The diagnostic sensitivity and specificity were, respectively, 88.8% and 87.5% in F1, 72.7% and 89.7% in F2, 81.3% and 98.6% in F3, and 80% and 97.4% in F4 when the GPR and APRI were connected in parallel; 86.6% and 90.2%, 78.4% and 96%, 78.6% and 97.4%, and 73.2% and 97.9%, respectively, when the GPR and APRI were connected in series; 80.2% and 89%, 65% and 89%, 70.3% and 98.5%, and 78.8% and 96.8%, respectively, when the GPR and FIB-4 were connected in parallel; and 83.6% and 87.9%, 76.8% and 96.6%, 72.7% and 98%, and 74.4% and 97.7%, respectively, when the GPR and FIB-4 were connected in series.CONCLUSION The GPR, as a serum diagnostic index of liver fibrosis, is more accurate, sensitive, and easy to use than the FIB-4 and APRI, and the GPR can significantly improve the sensitivity and specificity of hepatic fibrosis diagnosis in CHB when combined with the FIB-4 or APRI.
文摘The FIB-4 index is a simple and noninvasive algorithm consisting to evaluate liver fibrosis in chronic HCV infection. Aim: To evaluate the utility of FIB-4 index as a noninvasive marker to assess liver fibrosis in chronic HCV infection in comparison to transient elastography. Patients and Methods: We studied 30 patients having chronic HCV infection based on clinical features, laboratory tests, diagnostics images, Fibroscan and FIB-4 score. According to the results of Fibroscan, the 30 patients were classified into two groups in order to obtain a cutoff value to exclude patient with significant fibrosis: group Ia: 7 patients with no or mild liver fibrosis (F0-F1) and group Ib: 23 pa-tients with significant fibrosis or cirrhosis (F2-F3-F4). Group IIa: 17 patients with no or significant fibrosis (F0-F1-F2-F3) and group IIb (F4): 13 patients with cirrhosis (F4). Results: The mean of FIB-4 index increased with the increase of the fibrosis score. FIB-4 index proved to be sensitive and specific in differentiation between patients with no or mild fibrosis (F0-F1) and patients with significant fibrosis or cirrhosis (F2-F3-F4) with the best cutoff value at 1.61. It also proved to be sensitive and specific in differentiation between patients with no or significant fibrosis (F0-F1-F2-F3) and patients with cirrhosis (F4) with cutoff value at 1.88. Conclusion: The FIB-4 index enabled the correct identification of extreme types of fibrosis. Using these cutoffs (1.61 - 1.88), 87% of patients fell outside these ranges and could thus avoid liverbiopsy with an overall accuracy of 70%.
文摘目的探讨FIB-4(fibrosis index based on the 4 factor)指数对慢性乙型肝炎患者肝纤维化诊断价值。方法检测86例慢性乙肝患者血清ALT(谷丙转氨酶)、AST(谷草转氨酶)、PLT(血小板)等指标,根据病理肝纤维化分期设定两个判定点,分别为显著纤维化(≥S2级)和肝硬化(S4级),采用FIB-4指数加以评分,以肝组织病理学检查作对比,根据受试者工作特征曲线(AU-ROCs)评价FIB-4对于肝纤维化的诊断价值。结果FIB-4指数采用AUROCs加以评价,显示FIB-4≥S2级(显著纤维化)AUC曲线下面积为0.813,以1.56分值为界值,诊断显著肝纤维化敏感性、特异性、PPV和NPV分别达到86.21%、71.43%、86.2%和71.4%。S4级(肝硬化)AUC曲线下面积为0.802,以2.2分值为界值,诊断肝硬化敏感性、特异性、PPV和NPV分别达到87.5%、67.14%、37.8%和95.9%。结论FIB-4指数是一种简单易行、预测结果可靠的非侵入诊断方法,在一定程度上可替代肝活检。
文摘目的系统评价FIB-4预测慢性肝病患者出现肝细胞癌的价值。方法检索PubMed、Web of Science、中国知网和万方数据库中有关FIB-4预测慢性肝病患者肝细胞癌风险的文献,并根据纳入和排除标准筛选,利用RevMan 5.3软件进行统计分析。结果共纳入文献35篇,包含肝细胞癌患者94569例。Meta分析结果显示:慢性肝病患者基线高FIB-4(HR=1.57,95%CI:1.41-1.75,P<0.01)及抗病毒治疗后高FIB-4(HR=2.40,95%CI:1.74-3.32,P<0.01)与慢性乙肝或慢性丙肝患者的高肝细胞癌风险有关。结论FIB-4可预测慢性肝病患者的肝细胞癌风险。
文摘目的探讨NT-proBNP(N-terminal pronatriuretic peptide,NT-proBNP)、Hcy(Homocysteine,Hcy)、D-二聚体(D-dimer,D-D)和FIB(forward information data base,FIB)检测在慢性心力衰竭中的临床价值。方法选取2016年1月~2017年1月在我院住院治疗的慢性心力衰竭患者50例,同期选择在本院体检中心接受健康体检的健康人50例作为对照组,比较两组的NT-proBNP、Hcy、D-二聚体和FIB的水平,以及不同心功能分级慢性心力衰竭患者的NT-proBNP、Hcy、D-二聚体和FIB水平。结果疾病组患者的NT-proBNP、Hcy、D-D和FIB水平显著高于对照组,差异具有统计学意义(P<0.05)。Ⅳ级组患者的NT-proBNP、Hcy、D-D和FIB水平显著高于Ⅱ级、Ⅲ级组,差异具有统计学意义(P<0.05)。随着心功能分级的增加,NT-proBNP、Hcy、D-二聚体和FIB水平逐渐增加。结论 NT-proBNP、Hcy、D-二聚体和FIB各项指标的检测对于慢性心力衰竭的诊断具有临床价值,且可以作为评价慢性心力衰竭严重程度的重要参考指标。
