关键词: 乙型肝炎, 肝纤维化, CT扫描, 肝细胞外基质体积分数, 烟酰胺腺嘌呤二核苷酸磷酸氧化酶2, 几丁质酶样蛋白40, 诊断

Abstract: Objective The aim of this study was to investigate CT-measured extracellular volume fraction (fECV) in combination with serum nicotinamide adenosine diphosphate oxidase 2 (NOX2) and chitinase-3-like protein 1 (YKL-40) levels in predicting hepatic fibrosis (HF) in patients with chronic hepatitis B (CHB). Methods A total of 113 patients with CHB were encountered in Xingtai Central Hospital between May 2023 and May 2025, and all of them underwent CT scan to measure fECV and liver biopsy. Serum NOX2 and YKL-40 levels were detected by ELISA. Multivariate Logistic regression analysis was applied to analyze the factors influencing the degree of HF in patients with CHB, and the receiver operating characteristic (ROC) curve and its area under the curve (AUC) were used to evaluate diagnostic efficacy. Results Of the 113 patients with CHB, liver histo-pathological examination found stage F0 of HF in 13 cases, stage F1 in 34 cases (e.g., non-significant HF in 47 cases),stage F2 in 38 cases, stage F3 in 18 cases (significant HF in 56 cases), and stage F4 in 10 cases; fECV, serum NOX2 and YKL-40 levels in significant HF group were (35.1±10.4)%, (16.8±3.4)ng/mL and (31.1±8.2)ng/mL, all much higher than [(26.9±7.6)%, (9.6±2.5)ng/mL and (21.6±6.5)ng/mL, respectively,P＜0.05] in non-significant HF group; multivariate Logistic regression analysis showed that fECV(OR=1.696,95%CI:1.057-2.719), NOX2(OR=1.853,95%CI:1.025-3.350) and YKL-40(OR=0.441,95%CI:1.044-2.314) were all the independent impacting factors for HF in patients with CHB; ROC analysis demonstrated that the AUC was 0.914(95%CI:0.842-0.960),with sensitivity of 92.9% and specificity of 76.6%, when the fECV was combined with serum NOX2 and YKL-40 levels in predicting significant HF in patients with CHB, much superior to any single parameter doing (P＜0.05). Conclusion The combination of fECV, and serum NOX2 and YKL-40 levels could help clinicians initially screen liver fibrosis in patients with CHB, which might lead to further management.

Key words: Hepatitis B, Hepatic fibrosis, CT scan, Extracellular volume fraction, Nicotinamide adenosine diphosphate oxidase 2, Chitinase-3-like protein 1, Diagnosis