Laboratory Medicine ›› 2025, Vol. 40 ›› Issue (7): 625-641.DOI: 10.3969/j.issn.1673-8640.2025.07.001
Yueyang Hospital of Integrated Traditional Chinese and Western Medicine of Shanghai University of Traditional Chinese Medicine Shanghai Center for Clinical Laboratory, Clinical Laboratory Society of Chinese Association for Rehabilitation Medicine Clinical Laboratory Society of Chinese Association of Integrative Medicine, Tumor Immunology Branch of Shanghai Society for Immunology Molecular Diagnostics Society of Shanghai Medical Association
Received:2025-05-13
Revised:2025-07-07
Online:2025-07-30
Published:2025-07-28
CLC Number:
Yueyang Hospital of Integrated Traditional Chinese and Western Medicine of Shanghai University of Traditional Chinese Medicine Shanghai Center for Clinical Laboratory, Clinical Laboratory Society of Chinese Association for Rehabilitation Medicine Clinical Laboratory Society of Chinese Association of Integrative Medicine, Tumor Immunology Branch of Shanghai Society for Immunology Molecular Diagnostics Society of Shanghai Medical Association. Expert consensus on non-invasive laboratory diagnosis for hepatic fibrosis[J]. Laboratory Medicine, 2025, 40(7): 625-641.
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| 标志物 | 公式 | 适用对象 | 发布机构和发布年份 |
|---|---|---|---|
| APRI评分 | APRI=[AST（U·L-1）/AST（参考区间上限）×100]/PLT计数（×109L-1） | CHC、MAFLD、CHB、WD | 中华医学会肝病学分会等[ |
| FIB-4 | FIB-4=[年龄（岁）×AST（U·L-1）]/ [PLT计数（×109L-1）×√ALT（U·L-1）] | CHC、MAFLD、CHB、ALD、WD | 中华医学会肝病学分会[ |
| FibroTest模型 | FibroTest=4.467×lgα2-巨球蛋白-1.357× lg触珠蛋白+1.017×lg GGT+0.028 1× 年龄（岁）+1.737×lg总胆红素-（1.184×载脂蛋白A1）+0.301×性别（男性=1，女性=0）-5.540 | CHC、CHB、ALD、MAFLD | ACG[ |
| NFS | NFS=-1.675+0.037×年龄（岁）+ 0.094×BMI（kg·m-2）+1.13×IFG或糖尿病（有=1，无=0）+0.99×AAR-0.013×PLT计数（×109L-1）-0.66× 白蛋白（g·dL-1） | MAFLD | 中华医学会肝病学分会[ |
| GPR | GPR=[GGT/GGT参考区间上限×100]/ PLT计数（×109L-1） | CHB | 中华医学会肝病学分会等[ |
| RPR | RPR=RDW（%）/PLT计数（×109L-1） | CHB | 中华医学会肝病学分会等[ |
| AAR | AAR=AST（U·L-1）/ALT（U·L-1） | CHC、MAFLD | KASL[ |
| ELF | -7.412+0.681×ln HA+0.775×ln PⅢNP+ 0.494×ln TIMP1 | CHC、CHB、ALD、MAFLD、PSC | 中华医学会肝病学分会[ |
| ADAPT | exp[lg年龄（岁）×PRO-C3（ng·mL-1）/ √PLT计数（×109L-1）]+2型糖尿病 （有=1，无=0） | MAFLD | 中华医学会肝病学分会[ |
| ELFG模型 | Scheuer公式:D=-014×ln 年龄+0.616× ln HA+0.586×ln PⅢNP+0.472× ln TIMP-1-6.38； Ishak公式:D=-0.08×ln 年龄+0.608× ln HA+0.601×ln PⅢNP+0.511× ln TIMP1-6.26 | CHC、CHB、MASH、ALD、PBC/PSC | AASLD[ |
| FibroSpect II | 包括HA、TIMP1、α2-巨球蛋白3项指标（公式未公布） | CHC、MAFLD | AASLD[ |
| Hepascore | Hepascore=Y/（l+Y），Y= exp[-4.185 818-0.024 9×年龄+0.746 4 ×性别 （男性=1，女性=0）+1.003 9×α2-巨球蛋白（g/L）+0.030 2×HA（μg·L-1）+ 0.069 1×总胆红素（μmol·L-1）- 0.001 2×GGT（U·L-1）] | CHC、ALD | AASLD[ |
| Fibroindex | 1.738-0.064×PLT计数（×104/mm3）+ 0.005×AST（U·L-1）+0.463×γ-球蛋 白（g·dL-1） | CHC | AASLD[ |
| King's Score | 年龄×AST×INR/PLT计数（×109L-1） | CHC | AASLD[ |
| FibroMeter | 慢性病毒性肝病的公式:-0.007× PLT（g·L-1）-0.049×凝血酶原指 数（%）+0.012×AST（U·L-1）+0.005× α2-巨球蛋白（mg·dL-1）+0.021× HA（μg·L-1）-0.270×尿素（mmol·L-1）+ 0.027×年龄（岁）+3.718； ALD的公式:-0.169×凝血酶原指 数（%）+0.015×α2-巨球蛋白（mg·dL-1）+ 0.032×HA（μg·L-1）-0.140×年龄（岁）+ 16.541 | CHB、CHC、ALD | AASLD[ |
| Easy Liver Fibrosis Test（Elift） | 由年龄（岁）、性别、AST（U·L-1）、GGT（U·L-1）、PLT（g·L-1）、PT（%）组成的评分系统 | ALD、CHC、CHB、MAFLD | AASLD[ |
| Forns index | 7.811-3.131×ln PLT计数（×109L-1）+ 0.781×ln GGT（U·L-1）+3.467× ln 年龄（岁）-0.014×胆固醇（mg·dL-1） | CHC、ALD | KASL[ |
| BARD评分 | AAR≥0.8=2分，BMI≥28（kg·m-2）=1分，2型糖尿病=1分 | MAFLD | KASL[ |
| FIBC3 | -5.939+0.053×年龄（岁）+0.076× BMI（kg·m-2）+1.614×2型糖尿病 （有=1，无=0）-0.009×PLT计数（×109L-1）+0.071×PRO-C3（ng·mL-1） | MAFLD | KASL[ |
| Fibrosis Probability Index（FPI） | FPI= e*/1+e*；其中，*=-10.929+1.827× ln AST+0.081×年龄+0.768×饮酒史（评分为0~2分）+0.385×胰岛素抵抗指数-0.447×总胆固醇 | CHC | KASL[ |
| 标志物 | 公式 | 适用对象 | 发布机构和发布年份 |
|---|---|---|---|
| APRI评分 | APRI=[AST（U·L-1）/AST（参考区间上限）×100]/PLT计数（×109L-1） | CHC、MAFLD、CHB、WD | 中华医学会肝病学分会等[ |
| FIB-4 | FIB-4=[年龄（岁）×AST（U·L-1）]/ [PLT计数（×109L-1）×√ALT（U·L-1）] | CHC、MAFLD、CHB、ALD、WD | 中华医学会肝病学分会[ |
| FibroTest模型 | FibroTest=4.467×lgα2-巨球蛋白-1.357× lg触珠蛋白+1.017×lg GGT+0.028 1× 年龄（岁）+1.737×lg总胆红素-（1.184×载脂蛋白A1）+0.301×性别（男性=1，女性=0）-5.540 | CHC、CHB、ALD、MAFLD | ACG[ |
| NFS | NFS=-1.675+0.037×年龄（岁）+ 0.094×BMI（kg·m-2）+1.13×IFG或糖尿病（有=1，无=0）+0.99×AAR-0.013×PLT计数（×109L-1）-0.66× 白蛋白（g·dL-1） | MAFLD | 中华医学会肝病学分会[ |
| GPR | GPR=[GGT/GGT参考区间上限×100]/ PLT计数（×109L-1） | CHB | 中华医学会肝病学分会等[ |
| RPR | RPR=RDW（%）/PLT计数（×109L-1） | CHB | 中华医学会肝病学分会等[ |
| AAR | AAR=AST（U·L-1）/ALT（U·L-1） | CHC、MAFLD | KASL[ |
| ELF | -7.412+0.681×ln HA+0.775×ln PⅢNP+ 0.494×ln TIMP1 | CHC、CHB、ALD、MAFLD、PSC | 中华医学会肝病学分会[ |
| ADAPT | exp[lg年龄（岁）×PRO-C3（ng·mL-1）/ √PLT计数（×109L-1）]+2型糖尿病 （有=1，无=0） | MAFLD | 中华医学会肝病学分会[ |
| ELFG模型 | Scheuer公式:D=-014×ln 年龄+0.616× ln HA+0.586×ln PⅢNP+0.472× ln TIMP-1-6.38； Ishak公式:D=-0.08×ln 年龄+0.608× ln HA+0.601×ln PⅢNP+0.511× ln TIMP1-6.26 | CHC、CHB、MASH、ALD、PBC/PSC | AASLD[ |
| FibroSpect II | 包括HA、TIMP1、α2-巨球蛋白3项指标（公式未公布） | CHC、MAFLD | AASLD[ |
| Hepascore | Hepascore=Y/（l+Y），Y= exp[-4.185 818-0.024 9×年龄+0.746 4 ×性别 （男性=1，女性=0）+1.003 9×α2-巨球蛋白（g/L）+0.030 2×HA（μg·L-1）+ 0.069 1×总胆红素（μmol·L-1）- 0.001 2×GGT（U·L-1）] | CHC、ALD | AASLD[ |
| Fibroindex | 1.738-0.064×PLT计数（×104/mm3）+ 0.005×AST（U·L-1）+0.463×γ-球蛋 白（g·dL-1） | CHC | AASLD[ |
| King's Score | 年龄×AST×INR/PLT计数（×109L-1） | CHC | AASLD[ |
| FibroMeter | 慢性病毒性肝病的公式:-0.007× PLT（g·L-1）-0.049×凝血酶原指 数（%）+0.012×AST（U·L-1）+0.005× α2-巨球蛋白（mg·dL-1）+0.021× HA（μg·L-1）-0.270×尿素（mmol·L-1）+ 0.027×年龄（岁）+3.718； ALD的公式:-0.169×凝血酶原指 数（%）+0.015×α2-巨球蛋白（mg·dL-1）+ 0.032×HA（μg·L-1）-0.140×年龄（岁）+ 16.541 | CHB、CHC、ALD | AASLD[ |
| Easy Liver Fibrosis Test（Elift） | 由年龄（岁）、性别、AST（U·L-1）、GGT（U·L-1）、PLT（g·L-1）、PT（%）组成的评分系统 | ALD、CHC、CHB、MAFLD | AASLD[ |
| Forns index | 7.811-3.131×ln PLT计数（×109L-1）+ 0.781×ln GGT（U·L-1）+3.467× ln 年龄（岁）-0.014×胆固醇（mg·dL-1） | CHC、ALD | KASL[ |
| BARD评分 | AAR≥0.8=2分，BMI≥28（kg·m-2）=1分，2型糖尿病=1分 | MAFLD | KASL[ |
| FIBC3 | -5.939+0.053×年龄（岁）+0.076× BMI（kg·m-2）+1.614×2型糖尿病 （有=1，无=0）-0.009×PLT计数（×109L-1）+0.071×PRO-C3（ng·mL-1） | MAFLD | KASL[ |
| Fibrosis Probability Index（FPI） | FPI= e*/1+e*；其中，*=-10.929+1.827× ln AST+0.081×年龄+0.768×饮酒史（评分为0~2分）+0.385×胰岛素抵抗指数-0.447×总胆固醇 | CHC | KASL[ |
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