RPR、ALBI和APRI对HBV相关肝硬化的诊断价值

目的探讨天门冬氨酸氨基转移酶与血小板计数比值(APRI)、清蛋白与总胆红素比值(ALBI)、红细胞分布宽度与血小板计数比值(RPR)对HBV相关肝硬化不同分期的诊断价值。方法收集2016年9月至2019年9月于湖北省鄂州市中心医院就诊的64例HBV相关肝硬化患者(LC组),30例慢性乙型肝炎患者(CHB组)和50例体检健康者(对照组)的临床及实验室检查资料,并将肝硬化患者64例分为代偿期(CC组)27例和失代偿期(DC组)37例。比较不同组RPR、ALBI和APRI,并绘制受试者工作特征曲线(ROC曲线)比较各指标对肝硬化不同分期的诊断效能。结果RPR、ALBI和APRI与肝硬化进展均呈正相关(均P<0.05),其预测肝硬化的ROC曲线下面积分别为0.932(95%CI 0.878~0.967)、0.853(95%CI 0.784~0.906)和0.782(95%CI 0.705~0.846)。RPR预测肝硬化的曲线下面积均高于APRI(均P<0.05)。亚组分析显示,RPR对CC组肝硬化的诊断效能明显优于ALBI和APRI。结论RPR是预测CHB患者早期肝硬化的可靠指标,且优于ALBI和APRI。

The diagnostic value of RPR,ALBI and APRI in HBV-related liver cirrhosis

Objective To investigate the diagnostic value of aspartate aminotransferase to platelet count(APRI),albumin to total bilirubin(ALBI),red blood cell distribution width to platelet ratio(RPR)in different stages of HBV related cirrhosis.Methods Clinical and laboratory data of 64 patients with HBV-related cirrhosis(LC group),30 patients with chronic hepatitis B(CHB group),and 50 healthy patients(control group)were collected from September 2016 to September 2019 in Ezhou Central Hospital in Hubei Province.A total of 64 cases with liver cirrhosis were divided into 27 cases in the compensated period(CC group)and 37 cases in the decompensated period(DC group).RPR,ALBI and APRI of different groups were compared,and receiver operating characteristic curve(ROC curve)was drawn to compare the diagnostic efficacy of each index in different stages of liver cirrhosis.Results RPR,ALBI and APRI were positively correlated with the progression of liver cirrhosis(all P<0.05).The areas under ROC curve for predicting liver cirrhosis were 0.932(95%CI 0.878-0.967),0.853(95%CI 0.784-0.906)and 0.782(95%CI 0.705-0.846),respectively.The area under the curve of RPR in predicting liver cirrhosis were higher than that of APRI(all P<0.05).Subgroup analysis showed that RPR was superior to ALBI and APRI in the diagnosis of cirrhosis in CC group.Conclusion RPR is a reliable index for predicting early cirrhosis in patients with chronic hepatitis B,and it is better than ALBI and APRI.