关键词: 乙型肝炎病毒携带者, 肝纤维化, 无创诊断, 效能

Abstract: Objective To investigate the diagnostic efficacy of four non-invasive diagnostic models in evaluating significant liver fibrosis in chronic asymptomatic hepatitis B virus carriers（ASC）. Methods 203 chronic ASCs were recruited in ourhospital between July 2015 and November 2017,and FIB-4 scoring systems,liver stiffness measure（LSM） by Fibroscan,aspartate aminotransferase/alanine aminotransferase ratio（AAR） and aspartate aminotransferase/platelet ratio index（APRI） were obtained. The liver biopsies were performed,and≥S2 was defined as significant liver fibrosis. The diagnostic efficacy was evaluated by area under ROC. Results Out of the 203 chronic ASCs,the liver histopathological examination showed that no liver fibrosis in 24（11.8%）,S1 in 143（70.4%）,S2 in 32（15.8%）,S3 in 3（1.48%） and S4 in l（0.5%）,with 36（17.7%） having ≥S2 liver fibrosis;the FIB-4 in 36 ASCs with ≥S2 was （2.2±1.6）,significantly higher than （1.3±0.9） in 167 with less than S2,and the LSM,AAR and APRI scores in ASCs with significant liver fibrosis were all significant higher than in those with less than S2 liver fibrosis [（15.3±5.1） vs. （6.3±4.2）,（0.8±0.4） vs. （0.5±0.1）,and （1.0±0.6） vs. （0.5±0.2）,P<0.01];the AUC in predicting significant liver fibrosis by LSM was 0.967（95%CI 0.945 to 0.990）,with sensitivity （Se） of 94.4% and specificity （Sp） of 86.0%,and that by AAR was 0.8（95%CI 0.821 to 0.966）,with Se of 72.2% and Sp of 99.4%,by APRI was 0.884（95%CI 0.810 to 0.958）,with Se of 72.2% and Sp of 99.8%,and by FIB4 was 0.792（95%CI 0.689 to 0.895）,with Se of 69.4% and Sp of 90.1%. Conclusion The application of the four non-invasive diagnostic model in predicting significant liver fibrosis in ASCs might help clinical managements,which warrants further multi-centre investigation.

Key words: Asymptomatic hepatitis B viral carriers, Liver fibrosis, Non-invasive diagnostic diag-