文章摘要
King指数无创诊断慢性HBV感染患者肝纤维化程度的预测价值
Predictive value of King’s index in noninvasive diagnosis of liver fibrosis degrees in patients with chronic hepatitis B virus infection
投稿时间：2020-02-05  
DOI：10.3969/j.issn.1000-0399.2020.05.003
中文关键词: 慢性乙型肝炎感染  肝脏穿刺病理诊断  肝纤维化  无创诊断模型  King指数
英文关键词: Hepatitis B virus infection  Pathological diagnosis of liver biopsy  Liver fibrosis  Noninvasive diagnosis  King’s score
基金项目:国家自然科学基金（项目编号：81900554）；中央引导地方科技创新项目（项目编号：201907d07050008）
作者单位E-mail
徐洪海 230022 合肥 安徽医科大学第一附属医院病理科  
郜玉峰 230022 合肥 安徽医科大学第一附属医院病理科 aygyf@126.com 
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中文摘要:
      目的 评价无创诊断模型King指数对慢性HBV患者纤维化程度的预测价值。方法 选择185例于2018年7月至2019年11月在安徽医科大学第一附属医院接受治疗，谷丙转氨酶（ALT）小于2倍正常值上限的慢性HBV患者进行常规实验室检查及肝脏活检检查，分析King指数、FIB-4和APRI与肝纤维化病理分期的相关性，并绘制三者的受试者工作特征曲线（ROC），探究King指数对HBV患者肝脏纤维化程度的预测价值。结果 King指数、FIB-4和APRI与肝纤维化程度的相关系数分别为0.488、0.404和0.440。King指数、FIB-4和APRI对显著肝纤维化（肝纤维化分期≥S2期）的曲线下面积（AUC）分别为0.764、0.710和0.737，对严重肝纤维化（肝纤维化分期≥S3期）的AUC分别为0.774、0.732和0.746。当King指数截断值为10.946时，诊断显著肝纤维化的敏感度和特异度分别为61.05%、79.10%；当King指数的截断值为12.315时，诊断严重肝纤维化的敏感度和特异度分别为69.54%、74.67%。结论 King指数对ALT小于2倍正常值上限的慢性HBV感染患者的肝纤维化具有一定的预测价值。
英文摘要:
      Objective To evaluate the value of King's score in predicting the degree of liver fibrosis in patients with chronic hepatitis B virus(HBV) infection with alanine aminotransferase (ALT) <2 times upper limit of normal (ULN). Methods A total of 185 chronic HBV infectionpatients were chosen, routine laboratory test and liver biopsy were carried out, the relevance of King's score, FIB-4 and APRI with liver fibrosis stage were analyzed, the receiver operating characteristic curve (ROC curve) of these three was drawn, and the predicting value of King's score was explored. Results King's score, FIB-4 and APRI were positively correlated with liver fibrosis (r=0.488, 0.404 and 0.440). The AUC of King's score, FIB-4 and APRI in diagnosis in significant liver fibrosis was 0.76, 0.71 and 0.74, respectively. The AUC of King's score, FIB-4 and APRI in diagnosis in advanced liver fibrosis was 0.77, 0.73 and 0.75, respectively. At the cut-off value of 10.946, King's score had a sensitivity of 61.05% and a specificity of 79.10% in diagnosis of significant liver fibrosis. At the cut-off value of 12.315, King's score had a sensitivity of 69.54% and a specificity of 74.67% in diagnosis of advanced liver fibrosis. Conclusions King's score has a certain predictive value of liver fibrosis in chronic HBV infection patients with ALT <2 ULN.
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