对慢性乙肝病人，使用无创模型检测肝硬化

　　摘要

　　目的：很少有慢性乙肝的无创检测模型，用来检测肝硬化。当前研究的目的是调查对无创模型SPRI和ASPRI进行诊断的准确性。

　　患者和方法：总共对346个进行持续治疗的慢性乙肝患者进行研究。使用无创模型AAR、API、APRI、SPRI、ASPRI与肝组织进行对比。

　　结果：AAR, APRI, SPRI, API, 和 ASPRI显著进入纤维化阶段（全部P<0.001）。在五个对纤维化预测的测试中，ASPRI诊断的准确性事最高的。346个人中的35人，使用ASPRI>12的底线，进行测定，将能够准确的测定肝硬化（96.3%的阳性预测值。相似的，对346个人中的120人，使用<5的值，进行测定，百分之百的阴性预测值。

　　结论：ASPRI能够准确地预测肝硬化，使用ASPRI扫描设备将有可能降低进行肝活检的慢性乙肝病人数量。

　　原文：

　　Noninvasive Models to Predict Liver Cirrhosis in Patients With Chronic Hepatitis B

　　Abstract

　　Objectives: Few noninvasive models of chronic hepatitis B (CHB) to predict liver cirrhosis have been studied.

　　The aim of the current study is to investigate the diagnostic accuracy of two simple novel models of spleen-platelet ratio index (SPRI) and age-spleen-platelet ratio index (ASPRI) in patients with CHB.

　　Patients and methods: A total of 346 consecutive treatment-naïve patients with CHB were retrospectively studied. The aspartate to alanine aminotransferase ratio (AAR), age-platelet index (API), aspartate aminotransferase to platelet ratio index (APRI), SPRI, and ASPRI were compared with liver histology.

　　Results: AAR, APRI, SPRI, API, and ASPRI correlated significantly to fibrosis stage (all P<0.001). The diagnostic accuracy of ASPRI was the highest among five tests for prediction of cirrhosis (area under receiver operating characteristic curve, AUROC=0.893). Using a cutoff score of ASPRI>12, the presence of cirrhosis could be correctly identified with a high accuracy (96.3% positive predictive value) in 35 (10.1%) of 346 patients. Similarly, using a cutoff of <5, the presence of cirrhosis could be totally excluded with 100% of negative predictive value in 120 (34.7%) of 346 patients.

　　Conclusion: ASPRI was accurate in predicting cirrhosis and screening with ASPRI has the potential to reduce the number of liver biopsies in CHB patients.