S指数评价轻型慢乙肝肝纤维化程度的诊断价值分析

摘要

Objective] To observe the diagnosis value of noninvasive diagnosis model S index used to evaluate the fibrosis degree of slight chronic hepatitis B(CHB). [Method] Trace back and investigate the routine serological indicators GGT, PLT, ALB and liver aspiration biopsy results of 63 cases of CHB;use noninvasive diagnosis formula to calculate:S index=1000×GGT/(PLT×ALB2),use ROC curve to analyze and evaluate the clinical diagnosis value of S index. [Result] S index is in positive relation with liver fibrosis degree. S index can forecast the fibrosis having or not with best truncation point 0.04h, the sensitivity 87.0%, specificity 47.5%and area under the curve(AUC) 0.690,close to 0. 7; in forecasting obvious fibrosis, with best truncation point 0.04h, sensitivity 100%,specificity 36.8%,AUC 0.664. [Conclusion] S index used for forecasting slight CHB having or not fibrosis has high value of diagnosis, but it has low correctness for diagnosing having or not obvious liver fibrosis.%[目的]探讨无创诊断模型S指数用于评价轻型慢性乙型肝炎（简称慢乙肝）患者肝纤维化程度的诊断价值。[方法]回顾性调查63例轻型慢乙肝患者血清学指标谷氨酰转肽酶（glutamyl transpeptidase, GGT）、血小板（blood platelet, PLT）、血清白蛋白（serum albumin, ALB）及活体肝穿刺病理结果。利用无创诊断公式计算S指数，作受试者工组特征曲线（receiver operating characteristic curve, ROC）及曲线下面积（area under concentration, AUC），分析及评估S指数的诊临床断价值。[结果] S指数值与肝纤维化程度成正相关。预测有无肝纤维发生时，最佳诊断阈值0.04、真阳性率87.0%、假阳性率47.5%、AUC 0.690，诊断准确度中等；预测明显肝纤维化的发生时，最佳诊断阈值0.04、真阳性率100%、假阳性率36.8%、AUC 0.664，诊断准确度较低。[结论] S指数用于预测轻型慢乙肝患者有无肝纤维化的发生有较高的诊断价值，但对于区分患者有无明显肝纤维化则诊断准确度较低。