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Objective:To construct a non-invasive predictive model for liver fibrosis in HBeAg positive chronic hepatitis B (CHB) patients with alanine aminotransferase (ALT) lower than 2 upper limit of normal (ULN).Methods:The clinical data of 279 HBeAg positive CHB patients with ALT<2×ULN admitted in Zhejiang Provincial People’s Hospital from October 2014 to December 2020 were retrospectively analyzed. According to the pathological results of liver biopsy, there were 117 cases of mild liver fibrosis (S0-S1) and 162 cases of significant liver fibrosis (S2-S4). The independent predictors of liver fibrosis were analyzed by multivariate logistic regression analysis and a noninvasive predictive model was constructed. The model for predicting the severity of liver fibrosis was evaluated by receiver operating characteristic curve (ROC).Results:Multivariate logistic regression analysis showed that age, prothrombin time (PT), aspartate aminotransferase (AST), anti-HBc and HBV DNA were independent predictors of liver fibrosis ( OR=1.055, 1.365, 1.027, 1.231, 0.763, all P<0.05). The area under the ROC curve (AUR) of the model was 0.772 (95% CI: 0.716-0.828, P<0.05), the sensitivity and specificity for the diagnosis of significant liver fibrosis were 79.5% and 70.9% at the cut-off value of 0.504. The AUC of APRI model and FIB-4 index model for assessing significant liver fibrosis in CHB patients with HBeAg-positive and ALT<2×ULN were 0.720 and 0.671, respectively, which were lower than that of the current model (all P<0.05). Conclusion:The noninvasive predictive model constructed in this study has a high diagnostic value for evaluating the severity of liver fibrosis in CHB patients with HBeAg positive and ALT<2×ULN.
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【Objective】 To explore the correlation of DAT-positive hemolytic anemia(HA) with gender, age, and ABO serological indicators (anti-A, anti-B, anti-AB, anti-D; Ac, Bc, Oc), so as to provide references for clinical diagnosis. 【Methods】 2 832 HA patients who had underwent DAT tests in the Second Affiliated Hospital of Xi′an Jiaotong University in recent years were divided into the positive-DAT patients ( n=382 )and negative-DAT patients (n=2 450 ) according to the testing results. The correlation between the positive-DAT patients and the sex, age and ABO serological indicators was analyzed using SPSS 25.0 statistical software. 【Results】 DAT-positive HA risk in women were significantly higher than men (OR=1.712, CI95%= [1.365, 2.147], P<0.01), and it differed significantly by ages; it increased significantly with the presence of positive anti-A, negative Ac (OR=1.429, CI95%= [1.150, 1.775] ; P<0.01), and positive Oc(OR=21.369, CI95%= [13.813, 33.057] ; P<0.01). Men aged 31~40 were prone to develop mixed type(OR=19.304, CI95%= [2.208, 168.751] ; P<0.01), women aged 41~50 were prone to cold antibody(OR=3.981, CI95%= [1.545, 10.259] ; P<0.01); anti-AB positive patients were prone to mixed type (OR=1.852, CI95%= [1.027, 3.339] ; P<0.05), Oc positive was prone to warm antibody(OR=4.018, CI95%= [1.386, 1.646], P<0.01). 【Conclusion】 DAT-positive HA is significantly correlated with gender and age, and is positively correlated with anti-A, Oc positive and Ac negative.
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Objective To explore the clinical value of alanine aminotransferase (ALT),aspartate aminotransferase(AST) and gamma-glutamine transpeptidase(GGT) in the diagnosis of hepatitis B-related hepatocellular carcinoma,and to provide reference for clinical diagnosis.Methods From November 2015 to November 2017,118 patients with hepatitis B-related primary liver cancer (hepatitis B-related primary liver cancer group) admitted to Tongji Huangzhou Hospital of Huazhong University of Science and Technology were selected.And 116 patients with cirrhosis (hepatocirrhosis group) and 114 healthy people were selected as control group.The levels of ALT,AST and GGT and the specificity and sensitivity of each index were compared among the three groups,and the ROC curve was analyzed.Results The levels of serum ALT,AST and GGT in the hepatitis B-related primary hepatocellular carcinoma group were higher than those in the cirrhosis group and the control group,and the above serum indicators in the cirrhosis group were higher than those in the control group [(267.1 ± 131.5) U/L vs.(31.2 ± 11.3) U/L vs.(17.4 ± 4.6) U/L,(76.6 ± 23.2) U/L vs.(45.2 ± 13.1) U/L vs.(24.3 ± 6.6) U/L,(125.3 ± 42.6) U/L vs.(53.1 ± 17.6)U/L vs.(22.4 ± 4.4)U/L,all P ＜ 0.05].ROC curve showed that the area under GGT curve was 0.85,under ALT curve was 0.78,and under AST curve was 0.73,the area under the combined diagnostic curve of the three indicators was 0.95.The sensitivity and specificity of three combined diagnosis were higher than those of ALT,AST and GGT.Conclusion The levels of serum ALT,AST and GGT in patients with hepatitis B-related primary liver cancer are elevated,and the combined diagnosis of the three indicators has high sensitivity and specificity,which is worthy of clinical reference.
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Objective@#To explore the clinical value of alanine aminotransferase(ALT), aspartate aminotransferase(AST) and gamma-glutamine transpeptidase(GGT) in the diagnosis of hepatitis B-related hepatocellular carcinoma, and to provide reference for clinical diagnosis.@*Methods@#From November 2015 to November 2017, 118 patients with hepatitis B-related primary liver cancer (hepatitis B-related primary liver cancer group) admitted to Tongji Huangzhou Hospital of Huazhong University of Science and Technology were selected.And 116 patients with cirrhosis (hepatocirrhosis group) and 114 healthy people were selected as control group.The levels of ALT, AST and GGT and the specificity and sensitivity of each index were compared among the three groups, and the ROC curve was analyzed.@*Results@#The levels of serum ALT, AST and GGT in the hepatitis B-related primary hepatocellular carcinoma group were higher than those in the cirrhosis group and the control group, and the above serum indicators in the cirrhosis group were higher than those in the control group[(267.1±131.5)U/L vs.(31.2±11.3)U/L vs.(17.4±4.6)U/L, (76.6±23.2)U/L vs.(45.2±13.1)U/L vs.(24.3±6.6)U/L, (125.3±42.6)U/L vs.(53.1±17.6)U/L vs.(22.4±4.4)U/L, all P<0.05]. ROC curve showed that the area under GGT curve was 0.85, under ALT curve was 0.78, and under AST curve was 0.73, the area under the combined diagnostic curve of the three indicators was 0.95.The sensitivity and specificity of three combined diagnosis were higher than those of ALT, AST and GGT.@*Conclusion@#The levels of serum ALT, AST and GGT in patients with hepatitis B-related primary liver cancer are elevated, and the combined diagnosis of the three indicators has high sensitivity and specificity, which is worthy of clinical reference.
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The clinical mortality rate of paraquat poisoning is high. At present, plasma paraquat concentration, urinary paraquat concentration, various scoring systems, and serological indicators are used to predict the prognosis of patients so that clinicians can estimate the condition of patient correctly and take appropriate treatment. Compared with other prediction Methods , serological indicators have the advantages of convenience, availability, low price, instant accuracy and repeatability, and have good predictive value for the prognosis of paraquat poisoning patients. In this paper, the research progress on the prognostic value of serological indicators in patients with paraquat poisoning in recent years is reviewed.