Diagnostic value of commonly used coagulation indexes in liver fibrosis of patients with chronic hepatitis B

Objective To study the role of commonly used coagulation indexes in diagnosis of liver fibrosis lesion in patients with chronic hepatitis B.Methods Four hundred and fifty-three chronic hepatitis B patients were involved to retrospectively analyze the liver fibrosis lesion extent in S0 ~ S4 stages.All patients were divided into no fibrosis group(S0 ~ S1 stage) and fibrosis group(S2 ~ S4 stage) based on the liver biopsy pathology results,and the difference of the levels of PT,APTT,TT,Fbg,PLT were compared between the two groups.The diagnostic value of the meaningful indexes in liver fibrosis was evaluated by binary logistic regression and ROC curve.Results The levels of PT,APTT,TT were higher in fibrosis group than those in no fibrosis group,but the PLT level was lower in fibrosis group than that in no fibrosis group,and there were no significant differences of Fbg levels between the two groups(P 0.05).PLT,PT,APTT and TT were combined to calculate the predictive value of liver fibrosis,and the regression equation of calculation was Pre = 1/[1 + e(-0.815-0.012PLT +0.238PT +0.022APTT +0.041TT)].The overall accuracy of the prediction for liver fibrosis was 74.4%.The AUC-Z of PLT,PT,APTT,TT and the predictive value to diagnose liver fibrosis were 0.706,0.619,0.581,0.575,0.723(P 0.05).The sensitivity and specificity of the corresponding largest Youden index were PLT(56.6%,75.2%),PT(35.7%,84.0%),APTT(48.6%,64.0%),TT(44.0%,72.0%),the predictive value(68.9%,68.8%).Conclusion The commonly used coagulation indexes PLT,PT,APTT,TT have a certain diagnostic significance for liver fibrosis lesion in patients with chronic hepatitis B.PT has high diagnostic specificity,while combined application has the higher diagnostic value.