Abstract: Objective The purpose of this study was to investigate diagnostic performance of combination of sound palpation tissue quantification (SPTQ) and FIB-4 index and AST/ALT ratio in evaluation of liver fibrosis in patients with hepatitis B (CHB). Methods 82 naïve patients with CHB were encountered in our hospital between March 2019 and March 2024, and all underwent liver biopsy for liver fibrosis staging. Shear wave velocity (SWV) was obtained by SPTQ, and FIB-4 index and AST/ALT ratio were calculated routinely. Multivariate Logistic regression analysis was conducted and receiver operating characteristic curve (ROC) and its area under curve (AUC) were applied to evaluate liver fibrosis in patients with CHB. Results Liver histo-pathological examination showed S1 in 7 cases, S2, e.g., significant fibrosis (SF) in 47 cases, S3 in 23 cases and S4 in 5 cases, e.g., advanced fibrosis (AF) in 28 cases; SWV, FIB-4 and ratio of AST/ALT in patients with AF were (1.5±0.2)m/s, (2.0±0.3) and (1.5±0.3), all significantly higher than [(0.9±0.2)m/s, (1.0±0.1) and (0.8±0.2), respectively, P＜0.05] in those with SF; percentages of hypertension and family history of hepatitis B were 32.1% and 75.0%, both much higher than 17.0% and 19.2% (P＜0.05), total serum bilirubin, serum GGT levels and HBV DNA loads were (24.6±5.3)μmol/L, (78.4±6.3)U/L and (5.8±1.1)lg U/ml, all much higher than [(15.5±3.2)μmol/L, (45.7±14.0)U/L and (3.7±1.0)lg U/ml, respectively, P＜0.05] in patients with SF; multivariate Logistic regression analysis showed that SWV, FIB-4 and ratio of AST/ALT were independent risk factors for occurrence of AF in patients with CHB(all P＜0.05); ROC analysis demonstrated that the AUC was 0.938(95%CI:0.862-0.979), with sensitivity of 92.4% and specificity of 86.2%, when combination of SWV, FIB-4 and ratio of AST/ALT was applied to predict AF. Conclusion Combination of SWV, FIB-4 and AST/ALT ratio could predict AF existence in nave patients with CHB, which is worthy of further study.

Key words: Hepatitis B, Liver fibrosis, Sound palpation tissue quantification, FIB-4 index, Aspartate aminotransferase/alanine aminotransferase ratio, Diagnosis