Abstract:

Objective To establish the noninvasive diagnostic model for liver fibrosis in patients with chronic hepatitis B（CHB）,and to investigate the role for diagnosis. Methods Serum liver fibrosis markers [platelet（PLT）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,gamma-glutamyltransferase（GGT）,alkaline phosphatase（ALP）,total bilirubin（TB）,albumin（Alb）,albumin to globulin（A/G） ratio,red blood cell distribution width（RDW）,prothrombin time activity（PTA）,fibrinogen（Fib） and hepatitis B e antigen（HBeAg）] were determined in 270 patients with CHB undergoing liver biopsy. The correlation between these indices and liver fibrosis stage of CHB patients was analyzed. Logistic regression analysis was performed to establish a diagnostic model,and the results were analyzed by receiver operating characteristic（ROC） curve and compared with established diagnostic models（APRI,FIB-4,AAR,GPR and RPR）. Results By Logistic regression analysis,the indices were analyzed,and the regression equation for new diagnostic model AFPPR,which was AFPPR =1/[1+EXP（-2.584-A/G ratio×1.426-PLT×0.013-PTA×0.016-Fib×0.605+RDW×0.364）],was set up. The area under curve（AUC） of AFPPR for the diagnosis of liver fibrosis was 0.80,which was bigger than those of the other 5 diagnostic models（P<0.01）. AAR had no diagnostic value for significant and severe liver fibrosio（P>0.05）. The AUC of AFPPR for severe liver fibrosis was 0.76,which was bigger than those of the other 5 diagnostic models. Compared with the AUC of the other 5 diagnostic models,there was no statistical significance,except for AAR（P=0.000）. Conclusions The established AFPPR diagnostic model for liver fibrosis can be used as clinical supplementary reference on the dynamic observation of liver fibrosis.

Key words: Noninvasive diagnostic model, Liver fibrosis, Chronic hepatitis B