APRI和Forns指数对慢乙肝肝纤维化的诊断价值

Objective To testify the clinical value of APRI and Forns index diagnosis liver fibrosis of chronic hepatitis B.Methods There were 172 patients with chronic hepatitis B who were underwent liver biopsy with their liver function, blood routine and blood fat taken simultaneously.Three different endpoints were studied according to liver fibrosis stage, namely without/light fibrosis (S0/S1) , significant fibrosis (S2/S3/S4) and cirrhosis (S4) .The area under the ROC curves (AUC) reflected its diagnostic values.Results The correlation coefficient between liver fibrosis stage and APRI/Forns index was 0.312 and 0.315, respectively (P<0.01) .The APRI and Forns index of fibrosis S4 were higher than those of S0, S1, S2 and S3 (P<0.05) .The AUC for significant fibrosis of APRI/Forns index was low to 0.7 while that for cirrhosis was high to 0.7.The sensitivity (SN) , specificity (SP) , positive predictive value (PPV) and negative predictive value (NPV) of APRI evaluating cirrhosis (S4) were 80%, 74%, 34.5% and 95.6%, respectively, while those of Forns index were 92%, 63%, 29.9% and 97.9%, respectively.Conclusion There is correlation between liver fibrosis stage and APRI/Forns index.APRI/Forns index can valuate fibrosis S4 in patients with chronic hepatitis B, however, it can not discriminate fibrosis S1, S2 and S3.