关键词: 慢性乙型肝炎, HBsAg, γ, -谷氨酰转肽酶, 肝纤维化

Abstract: Objective To assess the liver fibrosis by serum gama-glutamyltransferase（γ-GT） and HBsAg quantification（qHBsAg） ratio（GqHBsR） in patients with chronic hepatitis B. Methods A total of 232 patients with chronic hepatitis B were enrolled and all had liver biopsied. Serum γ-GT and HBsAg were detected. Liver fibrosis was believed to be significant as ≥S2 and to be mild or without fibrosis as less than S2 existed. Diagnostic efficacy of GqHBsR was assessed at different cut-off values for significant liver fibrosis by using receiver operating characteristic （ROC） curves. Results The area under ROC （AUC） of GqHBsR for significant liver fibrosis was 0.704. When the GqHBsR was greater than 9.570 for significant liver fibrosis,the sensitivity,specificity,positive predictive value（PPV） and negative predictive value（NPV） were 49.2%,88.2%,84.2% and 57.7%;When the GqHBsR was >10 for significant liver fibrosis,the specificity and PPV were 88.2% and 83.3%,respectively;When the GqHBsR was>20 for significant liver fibrosis,specificity and PPV were both 100%;When the GqHBsR was <2.4 for significant liver fibrosis,the sensitive and NPV were 98.4% and 81.8%,respectively;When the GqHBsR was <2 for significant liver fibrosis,the sensitive and NPV were both 100%;The area under ROC（AUC） of fibrosis index based on the 4 factor（FIB-4）,aspartate aminotransferase to platelet ratioindex（APRI）,γ-GT and HBsAg for significant liver fibrosis were 0.638,0.631,0.606 and 0.588,respectively,all were less efficient as compared to that of GqHBsR. Conclusion GqHBsR yields a higher AUC than aspartate aminotransferase to platelet ratio index,FIB-4,γ-GT or HBsAg. This noninvasive diagnostic models for determination of liver fibrosis might be useful in clinical practice.

Key words: Chronic hepatitisB, Gamma-glutamyltransferase, Hepatitis B surface antigen, Liver fibrosis