| 王劲秋,商斌仪,陈建杰,郑彦希,陈博武.血清GP73、hs-CRP联合APRI对慢性乙型肝炎患者肝纤维化和抗病毒治疗应答的评估价值[J].,2024,(1):74-78 |
| 血清GP73、hs-CRP联合APRI对慢性乙型肝炎患者肝纤维化和抗病毒治疗应答的评估价值 |
| Evaluation Value of Serum GP73, hs-CRP Combined with APRI in Evaluating Liver Fibrosis and Antiviral Therapy Response in Patients with Chronic Hepatitis B |
| 投稿时间：2023-08-17 修订日期：2023-09-12 |
| DOI：10.13241/j.cnki.pmb.2024.01.013 |
| 中文关键词: 慢性乙型肝炎 GP73 hs-CRP APRI 肝纤维化 抗病毒治疗 |
| 英文关键词: Chronic hepatitis B GP73 hs-CRP APRI Liver fibrosis Antiviral therapy |
| 基金项目:上海市卫健委中医药发展基金项目（2018LP035） |
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| 中文摘要: |
| 摘要 目的：探讨血清高尔基体蛋白73（GP73）、超敏C反应蛋白（hs-CRP）、天冬氨酸转氨酶/血小板比值指数（APRI）对慢性乙型肝炎（CHB）患者肝纤维化和抗病毒治疗应答的评估价值。方法：选择2019年1月至2022年1月我院收治的初诊CHB患者187例，根据肝穿刺活检分为无纤维化组41例、纤维化S1期组43例、纤维化S2期组39例、纤维化S3期组36例、纤维化S4期组28例；肝纤维化≥S2期患者给予抗病毒治疗，根据治疗应答情况分为应答组（n=76）和无应答组（n=27）。比较不同肝纤维化程度组、不同疗效组治疗前血清GP73、hs-CRP及APRI，采用受试者工作特征（ROC）曲线分析血清GP73、hs-CRP联合APRI对CHB抗病毒治疗无应答的预测价值。结果：血清GP73、hs-CRP水平及APRI纤维化S4期组高于纤维化S3期组，纤维化S3期组高于纤维化S2期组，纤维化S2期组高于纤维化S1期组，纤维化S1期组高于无纤维化组，不应答组高于应答组，各组比较差异有统计学意义（P＜0.05）。血清GP73、hs-CRP、APRI及联合预测CHB抗病毒治疗无应答的曲线下面积（AUC）分别为0.803、0.731、0.785和0.903，联合检测的预测准确率大于各指标单独检测。结论：血清GP73、hs-CRP及APRI与CHB患者肝纤维化程度及抗病毒治疗应答情况有关，联合检测对CHB肝纤维化患者抗病毒治疗无应答具有较高预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the evaluation value of serum Golgi protein 73 (GP73), high-sensitivity C-reactive protein (hs-CRP) and aspartate aminotransferase/platelet ratio index (APRI) in evaluating liver fibrosis and antiviral therapy response in patients with chronic hepatitis B (CHB). Methods: The 187 newly diagnosed CHB patients admitted to our hospital from January 2019 to January 2022 were selected as the research subjects. Based on liver biopsy results, they were divided into a non fibrosis group of 41 cases, a fibrosis S1 stage group of 43 cases, a fibrosis S2 stage group of 39 cases, a fibrosis S3 stage group of 36 cases, and a fibrosis S4 stage group of 28 cases; Patients with liver fibrosis≥S2 stage were treated with antiviral therapy and were divided into a response group (n=76) and a non-response group (n=27) based on the treatment response.The serum GP73, hs-CRP and APRI before treatment were compared between different liver fibrosis groups and different efficacy groups, the predictive value of serum GP73, hs-CRP combined with APRI for non-response to antiviral treatment of CHB were analyzed by receiver operating characteristic (ROC) curve. Results: The levels of serum GP73, hs-CRP and APRI fibrosis S4 group were higher than those in fibrosis S3 group, fibrosis S3 group was higher than that in fibrosis S2 group, fibrosis S2 group was higher than that in fibrosis S1 group, fibrosis S1 group was higher than that in non-fibrosis group, non-response group was higher than that in response group, and the differences were statistically significant (P<0.05). The area under the curve (AUC) of serum GP73, hs-CRP, APRI and combined prediction of non-response to antiviral therapy for CHB were 0.803, 0.731, 0.785 and 0.903 respectively, the prediction accuracy of combined detection was higher than that of each index alone. Conclusion: Serum GP73, hs-CRP and APRI are relate to the degree of liver fibrosis and the response to antiviral therapy in CHB patients, combine detection has a high predictive value for non-response to antiviral therapy in patients with CHB fibrosis. |
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