血清HBeAg阴性慢性乙型肝炎患者APRI、FIB-4和血清TGF-β1水平变化*

目的 调查血清HBeAg阴性的慢性乙型肝炎(CHB)患者天门冬氨酸氨基转移酶与血小板比值(APRI)、基于4因子指数(FIB-4)和血清转化生长因子-β1(TGF-β1)的变化。方法 2018年1月～2019年5月我院诊治的血清HBeAg阴性的CHB患者78例和同期健康人78例,采用ELISA法测定血清TGF-β1水平,常规检测血生化指标,计算APRI和FIB-4评分。CHB患者接受肝活检,并行肝纤维化分期。结果 CHB患者APRI评分为(0.9±0.4),显著高于健康人【(0.3±0.1),P<0.05】;FIB-4评分为(1.4±0.4),显著高于健康人【(0.5±0.2),P<0.05】,血清TGF-β1水平为(14.5±5.3)ng/ml,显著高于健康人【(7.4±3.5)ng/ml,P<0.05】;33例CHB患者肝组织F0～1者APRI评分为(0.5±0.2),显著低于24例肝组织F2者【(1.0±0.3),P<0.05】,显著低于12例肝组织F3者【(1.3±0.5),P<0.05】,也显著低于9例肝组织F4者【(1.8±1.6),P<0.05】;F0～1患者FIB-4评分为(0.9±0.3),显著低于F2患者【(1.5±0.4),P<0.05】,显著低于F3患者【(1.9±0.4),P<0.05】,也显著低于F4患者【(3.2±0.6),P<0.05】;F0～1患者血清TGF-β1水平为(9.7±3.6)ng/ml,显著低于F2患者【(10.5±4.4)ng/ml,P<0.05】,显著低于F3患者【(15.8±5.9)ng/ml,P<0.05】,也显著低于F4患者【(19.5±6.2)ng/ml,P<0.05】。结论 血清HBeAg阴性的CHB患者APRI、FIB-4和血清TGF-β1水平发生了显著的变化,随着肝纤维化程度的加重,这些指标变化更明显,可能有助于提高对肝纤维化的诊断。

Changes of APRI and FIB-4 scores in patients with serum HBeAg-negative chronic hepatitis B

Objective The aim of this study was to investigate the changes of ratio of aspartate aminotransferase to platelet counts (APRI), based on fibrosis-four (FIB-4) and serum transforming growth factor-β1 (TGF-β1) in patients with serum HBeAg negative chronic hepatitis B (CHB). Methods 78 patients with serum HBeAg-negative CHB and 78 healthy persons were enrolled in our hospital from January 2018 through May 2019, and the APRI, FIB-4 and serum TGF-β1 levels were detected or calculated. The liver biopsies were performed in all patients with CHB. Results The APRI score in patients with CHB was (0.9±0.4), which was significantly higher than that in the healthy group [(0.3±0.1), P<0.05] , the FIB-4 score was (1.4±0.4), significantly higher than [(0.5±0.2), P <0.05] in the healthy persons, and serum TGF-β1 level in patients with CHB was (14.5±5.3) ng / ml, which was significantly higher than [(7.4±3.5), P< 0.05] ng / ml in healthy persons; the APRI score in 33 patients with hepatic F0-1 fibrosis was (0.5±0.2), significantly lower than [(1.0±0.3),P<0.05] in 24 patients with F2, significantly lower than [1.3.±0.5), P<0.05】 in 12 patients with F3, and also significantly lower than [(1.8±1.6), P <0.05] in 9 patients with F4; the FIB-4 score in patients with F0-1 was (0.9±0.3), significantly lower than [(1.5±0.4), P < 0.05] in patients with F2, significantly lower than [(1.9±0.4), P <0.05] in patients with F3, and also significantly lower than [(3.2±0.6), P <0.05] in patients with F4; the serum TGF-β1 level in patients with F0-1 was (9.7±3.6) ng / ml, which was significantly lower [(10.5±4.4) ng / ml, P<0.05] in patients with F2, significantly lower than [(15.8±5.9) ng / ml, P<0.05] in patients with F3, and also significantly lower than [(19.5±6.2) ng / ml, P<0.05] in patients with F4. Conclusion The APRI and FIB-4 scores as well as serum TGF-β1 levels in serum HBeAg-negative patients with CHB increase greatly, which might help improve the diagnostic accuracy of liver fibrosis in this setting.