The Korean Journal of Gastroenterology (대한소화기학회지)

The Korean Society of Gastroenterology (대한소화기학회)
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Clinical Efficacy of AST/ALT Ratio and Platelet Counts as Predictors of Degree of Fibrosis in HBV Infected Patients without Clinically Evident Liver Cirrhosis

임상적으로 간경변증의 증후가 없는 만성 B형 간염에서 간섬유화의 지표로서 AST/ALT 비와 혈소판 수치의 임상적 유용성

Park, Soo-Young;Kang, Kyung-Hee;Park, Jee-Hyun;Lee, Jong-Hyup;Cho, Chang-Min;Tak, Won-Young;Kweon, Yeong-Oh;Kim, Sung-Kook;Choi, Yong-Hwan
박수영;강경희;박지현;이종협;조창민;탁원영;권영오;김성국;최용환

  • Published : 20040400
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Abstract

Background/Aims: Hepatic fibrosis is an important prognostic factor in chronic hepatitis B. Liver biopsy is a gold standard diagnostic tool but an invasive procedure, so it cannot be done on all patients. We evaluated the clinical efficacy of AST/ALT ratio and platelet counts as predictors of fibrosis in chronic hepatitis B. Methods: We reviewed retrospectively clinical records of 323 patients, who visited Kyungpook National University Hospital for chronic hepatitis B and underwent liver biopsy from September 1998 to May 2002. Correlation with laboratory parameters with hepatic fibrosis stage was identified. Results: Of 323 patients, there were 278 male patients with mean age 27 (9${\sim}$59). Platelet counts showed a significant correlation (r=-0.343, p=0.000), and AST/ALT ratio showed a weak but significant correlation (r=0.137, p=0.013) with fibrosis stage. Patients with severe fibrosis or cirrhosis (stage 3 and 4) can be identified to have AST/ALT ratio $\geq$1 and platelet counts $\leq$$150,000/mm^3$, which showed with positive predictive value of 66.7%. Sensitivity, specificity, and negative predictive value were 14.6%, 97.5%, and 77.0%, respectively. Conclusions: In chronic hepatitis B patients without clinical evidence of cirrhosis, severe hepatic fibrosis might be predicted using laboratory parameters of AST/ALT$\geq$1 in combination with platelet counts. However, its sensitivity is too low to replace liver biopsy.

Keywords

References

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