慢性乙型肝炎患者的FIB-4指数预测性能降低,同时患有与代谢功能障碍相关的肝病
Randa Taher Natour1,2, Motti Haimi1,3, Rawi Hazan4,5
1Technion Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa, Israel.
Journal of viral hepatitis
|September 8, 2025
概括
FIB-4指数准确地预测慢性乙型肝炎 (CHB) 患者的肝纤维化. 然而,其诊断性能在患有代谢功能障碍相关肝病 (MASLD) 的患者中是有限的,这凸显了改善非侵入性标志物的需要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 非侵入性诊断是一种非侵入性诊断.
- 肝纤维化评估 肝纤维化评估
背景情况:
- 慢性乙型肝炎 (CHB) 和代谢功能障碍相关性肝病 (MASLD) 的联合患病率正在增加.
- 在患有并发性MASLD的CHB患者中,评估肝纤维化的非侵入性标志物尚未得到充分研究.
研究的目的:
- 评估FIB-4指数用于CHB患者肝纤维化预测的诊断性能.
- 评估FIB-4在患有同时存在CHB和MASLD的特定亚组患者的实用性.
主要方法:
- 前性研究包括109名CHB和64名CHB-MASLD患者.
- 通过弹性学和FIB-4指数计算来测量肝硬度.
- 包括ROC曲线在内的统计分析,以确定诊断准确度.
主要成果:
- 在一般的CHB组中,FIB-4在预测纤维化方面表现强 (AUC=0.86).
- 在CHB-MASLD小组中,FIB-4的诊断准确性显著降低 (AUC=0.61,p=0.12).
- 与单独使用CHB的患者相比,CHB-MASLD患者的BMI,血糖失调和脂质失调都较高.
结论:
- 无论BMI如何,FIB-4指数是可靠的非侵入性CHB患者纤维化标志物.
- 在同时患有CHB和MASLD的患者中,FIB-4的诊断效用受到损害.
- 开发新的,准确的非侵入性工具对于管理CHB-MASLD患者至关重要.
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