关键词: 慢性乙型肝炎, γ-谷氨酰转肽酶/血小板比值, 肝纤维化, 无创诊断

Abstract: Objective To investigate the predictive of liver fibrosis by gamma-glutamyl-transpeptidase-to-platelet ratio （GPR） in patients with chronic hepatitis B viral infection with normal serum transaminase levels. Methods 202 patients with chronic HBV infection with normal serum transaminase levels were recruited in our hospital between 2010 and 2016,and all of them underwent liver biopsy. The GPR,AST/PLT ratio index （APRI） and fibrosis index based on the factor（FIB-4） were determined. The area under ROC（AUC） was used for diagnostic efficacy in predicting liver fibrosis. Results F1,F2,F3 and F4 were found in 82,60,39 and 21 cases by the liver biopsies as the gold standard;the GPR,APRI and FIB-4 in patients with F4 were 0.4（0.2,1.0）,（0.6±; 0.2） and 1.6（0.9,1.8）,respectively,while they were 0.2（0.2,0.4）,（0.6±; 0.2） and 0.9（0.9,1.2） in patients with F3,and 0.2（0.1,0.3）,0.4±; 0.2 and 0.9（0.7,1.3） in patients with F2,respectively,differences significant （P<; 0.05）;the AUC of GPR for significant fibrosis（≥F2）,for advanced fibrosis（≥F3） and liver cirrhosis（F4） were 0.739,0.790 and 0.824,respectively,significant higher than（0.547,0.731 and 0.736） by APRI （P<; 0.05）;the AUC of GPR for liver fibrosis≥F3 was 0.790,significant higher than FIB-4（0.748,P<; 0.05）,while the AUC of FIB-4 for liver fibrosis≥F2 was 0.777,significant higher than GPR （0.739,P<; 0.05）;there was no significant difference as respect to the efficacy to predict liver cirrhosis（F4） between FIB-4 and GPR （AUC=0.824 and 0.792,P>; 0.05）. Conclusion GPR might be used to predict the liver fibrosis stages in patients with chronic HBV infection with normal serum aminotransferase levels,which is better than APRI and might be used as a noninvasive biochemical prediction index in this settings.

Key words: Chronic hepatitis B, Gamma-glutamyl-transpeptidase-to-platelet ratio, Liver fibrosis, Noninvasive diagnosis