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目的 研究肝功能指数 (AAPea指数 )在慢性肝炎分度诊断中的意义。方法 对 80 0例慢性肝炎肝穿病例临床生化指标通过差别分析筛选 ,测定血清A/G、AST、PA、EP、与ALB与病理分级相关性 ,根据这些指标量化打分 ,计算肝功能指数 (AAPea指数 ) ,并进一步研究其与肝组织病理损伤的关系 ,通过受试者特征工作曲线 (SOCC)确定cut -off值。结果 AAPea指数与慢性肝炎肝组织炎症活动程度及纤维化程度相关系数分别为 0 5 5 9、0 5 45 (P <0 0 0 0 1) ,与病理分度相关系数为 0 5 2 9(P <0 0 0 0 1)。轻、重度cut-off值分别为小于 12分、大于 2 4分时 ,敏感性、特异性分别 0 818、0 789和 0 3 82、0 3 94,中度在 12～ 2 4分间敏感性、特异性为0 5 0 4、0 5 43 ,本临床与病理符合率比单项指标判定为高。结论 肝功能指数 (AAPea指数 )评估慢性肝炎组织炎症活动程度及纤维化程度有意义 ,但对重度评估效果较差 ,值得进一步研究。
Objective To study the significance of liver function index (AAPea index) in the diagnosis of chronic hepatitis. Methods The clinical biochemical indexes of 80 0 cases of chronic hepatitis with liver puncture were screened by differential analysis. The correlations of serum A / G, AST, PA, EP and ALB with pathological grade were determined. The scores of liver function index (AAPea Index), and further study of its relationship with the pathological damage of liver tissue, through the characteristics of the receiver operating characteristic curve (SOCC) to determine the cut-off value. Results The correlation coefficients between AAPea index and inflammatory degree and fibrosis degree of liver tissue in chronic hepatitis were 0 5 5 9,0 5 45 (P 0 01 0) respectively, and the correlation coefficient with pathological index was 0 5 2 9 (P <0 0 0 0 1). Light and severe cut-off values were less than 12 points and greater than 24 points, respectively, with sensitivity and specificity of 0 818, 0 789 and 0 3 82, 0 3 94, and moderate sensitivity of 12 2 4 , Specificity of 0 5 0 4,0 5 43, the clinical and pathological coincidence rate higher than the individual indicators. Conclusions The liver function index (AAPea index) is significant in assessing the degree of inflammatory activity and fibrosis in chronic hepatitis, but its effect on severe evaluation is poor and worthy of further study.