自贡地区7项肝纤维化血清学模型参考区间的建立
摘要
目的建立自贡地区表观健康人群红细胞分布宽度/血小板比率(RPR)、纤维化4-指数(FIB-4)、天门冬氨酸氨基转移酶/血小板比率(APRI)、γ-谷氨酰转肽酶/血小板比率(GPR)、天门冬氨酸氨基转移酶/丙氨酸氨基转移酶比率(AAR)、APRG指数(APRG)和S指数(S)的参考区间。方法分别采用希森美康XN-1000全自动血液分析仪和日立7600-020全自动生化分析仪检测4 038例表观健康的体检者血常规和肝功能指标,计算得到RPR、FIB-4、APRI、GPR、AAR、APRG及S。根据性别及年龄对数据进行分层,计算出参考区间。结果 RPR、APRI、GPR、AAR、APRG和S水平与性别及年龄均无关,其参考区间分别为0.000～0.641、0.064～0.639、0.032～0.585、0.063～5.083、0.012～0.868和0.016～0.271,而FIB-4与性别无关,但与年龄相关,≤40岁、>60岁及>40～60岁的FIB-4的参考区间分别为0.015～0.046、0.004～0.090和0.029～0.074。结论该地区RPR、APRI、GPR、AAR、APRG和S的参考区间可供临床医生和其他实验室参考。
引文
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[3]丁予昀,王海军,廖昭平,等.RPR在乙型肝炎性肝纤维化诊断和预测严重程度中应用价值的评价[J].中华检验医学杂志,2017,40(7):532-534.
[4]WANG H W,PENG C Y,LAI H C,et al.New noninvasive index for predicting liver fibrosis in Asian patients with chronic viral hepatitis[J].Sci Rep,2017,7(1):3259-3266.
[5]殷明刚,余建洪.自贡地区血清肾功能检验项目参考区间的建立及分析[J].四川医学,2016,37(3):277-280.
[6]WANG J,YAN X M,YANG Y E,et al.A novel predictive model using routinely clinical parameters to predict liver fibrosis in patients with chronic hepatitis B[J].Oncotarget,2017,8(35):59257-59267.
[7]郭晓俊,朱岭峰,徐翀,等.传统统计法与稳健统计法评价医学检验实验室能力验证结果比较[J].检验医学,2017,32(5):435-439.
[8]王祖煜,刘熠赫,张芮,等.2004-2013年中国乙型病毒性肝炎的流行病学特征研究[J].中国全科医学,2017,20(23):2879-2883.
[9]姜洁,戴生龙,徐建芳,等.江苏省传染病综合防治示范区乙型肝炎、肝硬化及肝癌的死亡趋势和疾病负担分析[J].江苏预防医学,2016,27(6):644-650.
[10]CHEN B D,YE B,ZHANG J,et al.RDW to platelet ratio:a novel noninvasive index for predicting hepatic fibrosis and cirrhosis in chronic hepatitis B[J].PLoS One,2013,8(7):e68780.
[11]MCPHERSON S,HARDY T,DUFOUR J F,et al.Age as a confounding factor for the accurate Non-Invasive diagnosis of advanced NAFLD fibrosis[J].Am J Gastroenterol,2017,112(5):740-751.
[12]阎道博,哈利达·夏尔甫哈孜,冯涓,等.酒精及代谢性因素对慢性乙型肝炎患者肝纤维化的作用[J].世界华人消化杂志,2013,21(8):694-699.
[13]LI J,GORDON S C,RUPP L B,et al.Long-term progression of viral load and serum markers of fibrosis among treated and untreated patients with chronic hepatitis B[J].J Gastroenterol Hepatol,2017,32(6):1250-1257.
[14]SANAI F M,FARAH T,ALBELADI K,et al.Diminished accuracy of biomarkers of fibrosis in low replicative chronic hepatitis B[J].BMC Gastroenterol,2017,17(1):101-104.
[15]HUANG R,WANG G Y,TIAN C,et al.Gamma-glutamyl-transpeptidase to platelet ratio is not superior to APRI,FIB-4and RPR for diagnosing liver fibrosis in CHB patients in China[J].Sci Rep,2017,7(1):8543.
[16]宋诗雅,朱肖鸿.S指数评价轻型慢乙肝肝纤维化程度的诊断价值分析[J].浙江中医药大学学报,2015,39(3):199-201.