Value analysis of liver histopathological fcatures and serological noninvasive diagnostic model in chronic hepatitis B patients with mild ALT abnormality
Objective:To analyze the liver pathological features of chronic hepatitis B(CHB)patients with alanine aminotransferase(ALT)＜2ULN(2ULN),and to evaluate the diagnostic value of different serological models for liver fibrosis.Methods:A retrospective analysis of 62 CHB patients with ALT＜2ULN and liver biopsy was performed in the Fourth People's Hospital of Huai'an City,Jiangsu Province from October 2019 to May 2023.The clinical data of patients were collected,and according to the results of liver tissue biopsy,the patients below S2 were classified as the group without obvious fibrosis(35 cases),and the patients above S2 were classified as the group with obvious fibrosis(27 cases).Two independent sample t test,Mann-Whitney U test and x2 test were used to analyze the clinical indicators of the two groups.Receiver operating characteristic curve(ROC)was used to analyze the diagnostic efficacy of international normalized ratio/platelet ratio(INPR),aspartate aminotransferase and platelet ratio index(APRI),liver fibrosis factor 4 index(FIB-4),γ-glutamyl transpeptidase and platelet ratio(GPR),and S index in pathological liver fibrosis.Spersman test was used to analyze the relationship between different noninvasive diagnostic models and hepatic fibrosis.Results:Among 62 CHB patients with ALT＜2ULN and liver puncture,the degree of fibrosis was S0 stage 16(25.8％),S1 stage 19(30.6％),S2 stage 19(30.6％),S3 stage 8 cases(12.9％).The correlation between the stratification of relevant clinical indicators and liver fibrosis in 62 patients was analyzed.Only the level of HBsAg(stratified by 3.0 × 103IU/ml)was statistically significant(x2=4.07,P=0.044).Results Analysis showed that there were significant differences in prohemase time(PT)and platelet count(PLT)between the two groups(P＜0.05).FIB-4(coefficient of correlation:0.432,P＜0.001),INPR(coefficient of correlation:0.426,P=0.001),APRI(coefficient of correlation:0.388,P=0.02),S index(coefficient of correlation:0.373,P=0.003),GPR(coefficient of correlation:0.307,P=0.015)were positively correlated with the degree of liver fibrosis.The highest area under the curve of INPR for diagnosing liver fibrosis(S≥2)is 0.739,the highest sensitivity is 66.7％,and the highest specificity of FIB-4 is 94.3％.Conclusion:ALT＜2ULN patients with CHB have a higher rate of liver fibrosis,among which HBsAg＜3.0 × 103IU/ml,prolongation of PT and decrease of PLT are risk factors.Five kinds of non-invasive diagnostic models have certain predictive value for the occurrence of liver fibrosis,and the changes of these models can be dynamically monitored in clinical practice to provide a basis for preliminary clinical screening.
chronic hepatitis Bliver pathologyfibrosisdiagnostic model
NETL
NSTL
万方数据
维普
