ABSTRACT
Objective To detect the changes of aspartate aminotransferase-to-platelet ratio index ( APRI) and fibrosis index based on the four factors (FIB-4) in patients with chronic HBV infection,and to analyze and evaluate the status of liver function,and explore the clinical significance in order to find a simple non-invasive diagnostic method for liver fibrosis. Methods From January 2016 to June 2017, a clinical controlled study was conducted to select one hundred and twenty patients with chronic HBV infection in outpatient and inpatient clinics of the Second Affiliated Hospital of Medical College of Qingdao University. They were divided into three groups: HBV carriers,chronic hepatitis B patients and hepatitis B cirrhosis patients. Serum total bilirubin,albumin,alanine aminotransferase (ALT),aspartate aminotransferase (AST) and platelet levels were measured. According to the formula, the values of APRI and FIB-4 were calculated,and the numerical changes of APRI and FIB-4 in patients with different types of chronic HBV infection were studied. The correlation between total bilirubin and albumin was analyzed. At the same time,30 healthy persons were selected as healthy control group for clinical analysis. Results The APRI values of patients with chronic HBV infection and healthy control group were ( 1. 17 ± 0. 71) and ( 0. 50 ± 0. 23), respectively. The FIB-4 values of patients with chronic HBV infection and healthy control group were (1. 90± 0. 84) and (1. 08±0. 58),respectively. The differences were statistically significant (P＜0. 01). The APRI values of HBV carriers group,chronic hepatitis B group and hepatitis B cirrhosis group were(0. 53±0. 22), (1. 14± 0. 61) and ( 1. 84 ± 0. 49) . The values of FIB-4 were ( 1. 22 ± 0. 54),( 1. 85 ± 0. 48) and ( 2. 64 ±0. 77) respectively. The values of APRI and FIB-4 of chronic HBV infection patients in each group increased with the increase of liver fibrosis, and there was significant difference between the groups ( P＜0. 01). The results showed that hepatitis B cirrhosis grouP＞chronic hepatitis B grouP＞HBV carrier grouP＞healthy control group. There were significant differences between hepatitis B group and healthy control group,hepatitis B cirrhosis group and HBV carrier group,chronic hepatitis B group and HBV carrier group (P＜0. 01). There was no significant difference between HBV carriers and healthy controls (P＞0. 05). The results of correlation analysis showed that there was a positive correlation among APRI, FIB-4 and total bilirubin (P＜0. 01) and a negative correlation with albumin ( P＜0. 01) in patients with chronic HBV infection. Conclusion The changes of APRI and FIB-4 values in patients with chronic HBV infection have diagnostic value for liver fibrosis in different clinical infection states can reflect the liver function status of patients,and help judge the severity and prognosis of patients with chronic HBV infection.
ABSTRACT
The humanistic solicitude in nursing means that the medical staffs take sincerely the patients' life, health, basic rights, needs, personalities and dignities into account with humanitarian spirit, which plays an important part in nursing practice. To implant humanistic solicitude in teaching and to innovate its model in multiple ways by using related theories of pedagogy, learning advanced experiences from hospitals domestic and abroad can cultivate students′ sustained and stable concept of humanistic solicitude and motivate their empathy and caring emotions, thereby expanding their knowledge and promoting the abilities of utilizing humanistic solicitude in nursing practice.