Abstract: Objective The aim of this study was to investigate the diagnostic efficacy of transient elastography in combination with aspartate aminotransferase (AST)/platelet count index (APRI) and AST/ alanine aminotransferase (ALT) ratio(AAR) in evaluating significant liver fibrosis in patients with chronic hepatitis B (CHB). Methods+++++118 patients with CHB were admitted to our hospital between May 2017 and May 2018, all received entecavir for treatment for 12 months, and all underwent liver biopsies. The liver stiffness measurement (LSM) was detected by FibroScan-502 transient elastography scanner. Blood routine and blood biochemical indexes were detected by BX800 full-automatic biochemical analyzer. The predictive value of LSM, evaluated by receiver operatingAPRI and AAR for diagnosing significant liver fibrosis in patients with CHB was characteristic (ROC) curves.Results Out of the 118 patients with CHB in our series, the liver fibrosis stage S_0-1 was found in 65 patients, and the S_2-4 (significant liver fibrosis) was found in 53 patients; serumALT and AST levels, APRI, AAR and LSM in patients with significant liver fibrosis were (128.3±31.4)U/L, (133.7±41.9)U/L, (0.5±0.2), (1.5±0.5) and (9.3±2.7)kPa, all significantly higher than 【(104.6±26.8)U/L, (93.4±40.2)U/L,(0.3±0.1), (1.2±0.3) and (5.6±1.6)kPa, respectively, P<0.05】, while peripheral blood PLC count was (123.4±46.4)×10⁹/L, significantly lower than 【(184.2±42.8)×10⁹/L, P<0.05】 in patients without liver fibrosis; we set the cut-off-value of 7.830(kPa), 0.350 and 1.310, respectively, and the AUC were 0.867(95%CI:0.827-0.947), 0.774(95%CI:0.678-0.861) and 0.687(95%CI:0.500-0.774) for LSM, APRI and AAR in diagnosing significant liver fibrosis, all significantly lower than 0.945(95%CI:0.904-0.986) for the three combination diagnosis (P<0.05); there were no significant changes in LSM, APRI and AAR after 12 month antiviral treatment in 65 patients without significant liver fibrosis, while the LSM was (7.4±1.2)kPa at the end of 12 month observation, significantly decreased as compared to 【(9.3±2.7)kPa, P<0.05】 at presentation in 53 patients with significant liver fibrosis.Conclusion The application of LSM, in combination with APRI and AAR maybe, is of good predictive value in evaluating significant liver fibrosis in patients with CHB, and warrants further investigation.

Key words: Hepatitis B, Liver fibrosis, Transient elastography, Aspartate aminotransferase /platelet count index, AST/ alanine aminotransferase ratio, Diagnosis