首页|血清CHI3L1、FibroTouch、APRI、FIB-4对乙型肝炎肝纤维化的影响及诊断价值研究

血清CHI3L1、FibroTouch、APRI、FIB-4对乙型肝炎肝纤维化的影响及诊断价值研究

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  • NETL
  • NSTL
  • 万方数据
  • 维普
目的:评估血清CHI3L1、FibroTouch、天门冬氨酸氨基转移酶(AST)和血小板计数(PLT)比率指数(APRI)、肝纤维化4因子指数(FIB-4)在丙氨酸氨基转移酶(ALT)<2 倍正常值上限(ULN)慢性乙型肝炎病毒(HBV)感染患者中的无创诊断价值.方法:回顾性纳入2018 年11 月至2021 年11 月在杭州市西溪医院住院行肝穿刺活检的ALT<2 倍ULN慢性HBV感染患者,根据肝纤维化程度分为非显著肝纤维化(NSLF)组和显著肝纤维化(SLF)组.收集患者的一般资料及血清CHI3L1、白蛋白(Alb)、肝功能及肝脏硬度值(LSM)等相关检验检查指标.经单因素和多因素向前逐步二元Logistic回归分析并构建回归模型,分析各无创检测用于显著性肝纤维化的价值.结果:共纳入 69 例慢性HBV感染患者,其中NSLF组 38 例,SLF组 31 例.SLF组的血清CHI3L1、LSM、APRI、ALT和AST均显著高于NSLF组(P<0.05),Alb显著低于NSLF组(P<0.05).血清CHI3L1 和LSM是SLF的独立影响因素(P均<0.05),Alb、PLT 和脂肪衰减不是 SLF 的独立影响因素.将血清 CHI3L1 和 LSM 纳入回归模型,回归方程为:Y =-4.220 +0.029×血清CHI3L1 +0.311×LSM.对于SLF的诊断价值,CL模型和血清CHI3L1 的AUC分别为0.767和0.696.结论:血清CHI3L1 和LSM是慢性HBV感染患者SLF的独立影响因素.血清CHI3L1 联合LSM对慢性HBV感染患者诊断SLF具有一定的临床参考价值.
Effect and diagnostic value of serum CHI3L1,FibroTouch,APRI and FIB-4 on hepatic fibrosis in patients with chronic hepatitis B virus infection
Objective:Assess the noninvasive diagnostic value of serum Chitinase-3-like protein 1(CHI3L1),FibroTouch,aspartate aminotransferase(AST)and platelet ratio index(APRI),and hepatic fibrosis 4 factor index(FIB-4)in patients with glutamate aminotransferase(ALT)<2 times the upper limit of normal(ULN)chronic hepatitis B virus(HBV)infection.Methods:Patients with chronic HBV infection who underwent liver biopsy and ALT<2 times Upper Limit Of Normal(ULN)in Xixi Hospital of Hangzhou from November 2018 to November 2021 were included in this study.According to the degree of liver fibrosis,the patients were divided into non-significant liver fibrosis(NSLF)group and significant liver fibrosis(SLF)group.The general data and serum CHI3L1,albumin(Alb),liver function and liver stiffness measurement(LSM)were collected.Univariate and multivariate forward stepwise binary Logistic regression analysis were used to construct regression models to analyze the value of each non-invasive test in judging significant liver fibrosis.Results:A total of 69 patients with chronic HBV infection were enrolled in this study,including 38 patients in the NSLF group and 31 patients in the SLF group.Serum CHI3L1,LSM,APRI,ALT and AST in the SLF group were significantly higher than those in the NSLF group(P<0.05),and Alb was significantly lower than that in the NSLF group(P<0.05).3.Serum CHI3L1 and LSM are independent influencing factors of SLF(P<0.05),Alb,platelet(PLT)and controlled attenuation parameter are not independent influencing factors of SLF.Serum CHI3L1 and LSM were included in the regression model(CL model)with the regression equation:Y =-4.220 +0.029×serum CHI3L1 +0.311×LSM.4.For the diagnostic value of SLF,the CL model and serum CHI3L1 were 0.767 and 0.696,respectively.Conclusion:Serum CHI3L1 and LSM are independent influencing factors of SLF in patients with chronic hepatitis B virus infection.And serum CHI3L1 combined with LSM has certain clinical reference value for the diagnosis of SLF in patients.

chitinase 3-like protein 1chronic hepatitis Bliver fibrosis

胡祯轩、吕铁锋

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杭州市余杭区第三人民医院感染科 (浙江 杭州,311100)

浙江大学医学院附属杭州市西溪医院内五科

壳多糖酶3样蛋白1 慢性乙型肝炎病毒感染 肝纤维化

2024

10.3969/j.issn.1005-0264.2024.004.009

中西医结合肝病杂志
中国中西医结合学会,湖北中医学院

中西医结合肝病杂志

CSTPCD
影响因子：0.908
ISSN：1005-0264
年,卷(期)：2024.34(4)
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