ABSTRACT
Objective:To detect the level of serological indexes in patients with chronic hepatitis B and carry out magnetic resonance imaging (MRI) examination at the same time, so as to construct a diagnostic model for liver fibrosis and evaluate its diagnostic value.Methods:A total of 267 patients with chronic hepatitis B in Fushun Central Hospital from January 2018 to June 2020 were selected as the research objects. The apparent diffusion coefficient (ADC) was measured by introvoxel incoherent motion (IVIM) magnetic resonance imaging, and the related serological indexes were detected; Pearson method was used to analyze the correlation among Frons index, aspartate aminotransferase to platelet ratio index (APRI), fibrosis index based on the 4 factor (Fib-4), red blood cell volume distribution width to platelet ratio (RPR) and ADC; Logistic regression analysis was used to establish a new diagnosis model of hepatic fibrosis; receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of liver fibrosis model.Results:The pathological examination of 267 patients with chronic hepatitis B showed that there were 35 cases in F0 stage, 47 cases in F1 stage, 58 cases in F2 stage, 66 cases in F3 stage and 61 cases in F4 stage. There were significant differences in platelet (PLT), alanine aminotransferase (ALT), gamma glutamyl transferase (GGT), aspartate aminotransferase (AST), prothrombin activity (PTA), collagen Ⅳ (CⅣ), laminin (LN), hyaluronic acid (HA), precollagen Ⅲ (PCⅢ), Frons index, aspartate aminotransferase to platelet ratio index (APRI), fibrosis index based on the 4 factor(Fib-4), red blood cell volume distribution width to platelet ratio (RPR) and ADC in patients with mild liver fibrosis (F0-F1), moderate liver fibrosis (F2-F3) and severe liver fibrosis (F4) ( P<0.05). Pearson analysis showed that Frons index, APRI, Fib-4, RPR and ADC were positively correlated ( P<0.05). The comparison of value of logistic probability risk estimating (PRE) and Frons index, APRI, Fib-4, RPR in the diagnosis of chronic hepatitis B liver fibrosis showed that the area under the curve (AUC) of Frons index, Fib-4 and APRI in the diagnosis of moderate liver fibrosis were higher than that of mild and severe liver fibrosis, with AUC of 0.903, 0.928 and 0.957, respectively; the AUC of RPR in the diagnosis of mild and moderate hepatic fibrosis was higher (0.861); the AUC of PRE in the diagnosis of mild, moderate and severe liver fibrosis was 0.860, 0.861 and 0.865, respectively; the sensitivity was 64.6%, 76.6%, 73.8%, and the specificity was 96.3%, 89.5% and 95.1%, respectively. Conclusions:Frons index, APRI, Fib-4, RPR and PRE liver fibrosis diagnostic models have certain diagnostic value. Among them, the liver fibrosis diagnostic model predicted by MRI and serological indexes has the best comprehensive efficiency. The best diagnostic scheme should be selected according to the actual situation.
ABSTRACT
Objective:To investigate the syndromes distribution in patients with dysfunctional uterine bleeding(DUB) related to kidney deficiency, and to provide the basis for standardizing the DUB syndrome differentiation of kidney deficiency. Methods: DUB Patients with kidney deficiency were chosen and accepted epidemical survey through the questionnaire, then the frequency and constituent ratio of each syndrome were calculated. Results: In 612 cases of DUB patients with kidney deficiency, there were 102 patients with simple syndromes covered 16.67%, and 510 patients with compound syndromes covered 83.33%. In patients with simple syndromes, the common syndromes were kidney-yin deficiency(45,44.12%) and kidney-qi deficiency(45,41.18%). And the syndromes of kidney-qi deficiency and kidney-yin deficiency were often respctively complicated with liver stagnation(68,11.09%; 113,18.43%), blood defi ciency(57,9.30%; 99,16.15%) and blood stasis(57,9.30%; 99,16.15%), the syndrome of kidney-yang deficiency usually complicated with spleen-qi deficiency(75,12.23%). The syndrome of kidney-qi deficiency(186,57.23%) was commonly-seen in the patients with ovular DUB, while the syndromes of kidney-qi(146,50.69%) and kidney-yin deficiency(111,38.54%) were frequently-seen in the patients with anovular DUB. Conclusion: In clinic, the compound syndromes were commonly seen in patients with DUB due to kidney deficiency, the complicated syndromes of kidney deficiency were liver stagnation, spleen-qi deficiency, blood deficiency and blood stasis..