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Diagnostic value of FIB-4, aspartate aminotransferaseto-platelet ratio index and liver stiffness measurement in hepatitis B virus-infected patients with persistently normal alanine aminotransferase

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World Journal of Gastroenterology 2017年第31期23卷 5746-5754页

作者： You-Wen Tan Xing-Bei Zhou Yun Ye Cong He Guo-Hong Ge Department of Hepatology the Third Hospital of Zhenjiang Affiliated Jiangsu University

AIM To assess the diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index(APRI), and liver stiffness measurement(LSM) in patients with hepatitis B virus infection who have persistently normal alanine transaminase(PNALT).METHODS We enrolled 245 patients with chronic hepatitis B: 95 in PNALT group, 86 in intermittently elevated alanine transaminase(PIALT1) group [alanine transaminase(ALT) within 1-2 × upper limit of normal value(ULN)], and 64 in PIALT2 group(ALT > 2 × ULN). All the patients received a percutaneous liver biopsy guided by ultrasonography. LSM, biochemical tests, and complete blood cell counts were *** The pathological examination revealed moderate inflammatory necrosis ratios of 16.81%(16/95), 32.56%(28/86), and 45.31%(28/64), and moderate liverfibrosis of 24.2%(23/95), 33.72%(29/86), and 43.75%(28/64) in the PNALT, PIALT1, and PIALT2 groups, respectively. The degrees of inflammation and liver fibrosis were significantly higher in the PIALT groups than in the PNALT group(P 0.05) was found in AUCs for all comparisons(P > 0.05 for all). In the overall patients, a significant difference in the AUCs was found only between LSM and APRI(P < 0.05).CONCLUSION APRI and FIB-4 are not the ideal noninvasive hepatic fibrosis markers for PNALT patients. LSM is superior to APRI and FIB-4 in PNALT patients because of the influence of liver inflammation and necrosis.

关键词： Liver stiffness measurement Hepatitis B virus FIB-4 aspartate aminotransferase-to-platelet ratio index Normal Alanine aminotransferase

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Simple non-invasive biomarkers of advanced fibrosis in the evaluation of non-alcoholic fatty liver disease

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Gastroenterology Report 2014年第4期2卷 276-280页

作者： Elliot B.Tapper Katherine Krajewski Michelle Lai Tracy Challies Robert Kane Nezam Afdhal Daryl Lau Division of Gastroenterology Beth Israel Deaconess Medical CenterBostonMA USA Division of Radiology Beth Israel Deaconess Medical CenterBostonMAUSA Division of Pathology Beth Israel Deaconess Medical CenterBostonMAUSA

Background and ***-alcoholic fatty liver disease(NAFLD)is a common,morbid disease with profound implications for the overall health of the *** set out to determine the clinical predictors of advanced histology in the referral *** performed a retrospective review of all biopsy-proven NAFLD patients,including 358 unique patients first seen between 1996 and *** histology and ultrasound images were reviewed prospectively by clinicians who were blinded to clinical information and test *** with men,women tended to present at an older age(51.4-10.6 vs 45.3-11.2 years,Paminotransferase(ALT)(75.2%vs 88.8%),and more likely to have advanced non-alcoholic steatohepatitis(NASH)(44.7%vs 29.9%;P=0.04)and advanced fibrosis(23.3%vs 14.1%;P=0.03).In multivariate logistic regression,body mass index(BMI)-30 kg/m^(2)(odds ratio(OR)2.21;95%confidential interval(CI):1.23–4.08),female gender(OR 1.76;95%CI:1.01–3.10)and aspartate aminotransferase(AST)>40 IU/L(OR 2.00;95%CI:1.14–3.55)were associated with a NAFLD activity score>*** sensitivity and specificity of an AST to platelet ratio index(APRI)>1 for significant fibrosis was 30.0%(95%CI:17.2–45.4%)and 92.8%(95%CI:88.2-95.8%),respectively;the likelihood ratio is *** multivariate logistic regression,APRI>1 was the most significant predictor of advanced fibrosis(OR 3.85;95%CI:1.55–9.59).In patients without ultrasound-detected steatosis,20%had advanced fibrosis and 16.7%had active *** with suspected NAFLD should routinely be evaluated for advanced liver disease,including non-invasive indices of fibrosis such as APRI,and serious consideration given to liver biopsy.

关键词： cirrhosis non-alcoholic fatty liver disease non-alcoholic steatohepatitis aspartate aminotransferase-to-platelet ratio index

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