| 乙肝肝纤维化无创诊断模型的研究 |
| Alternative Title | The study of non-invasive diagnosis model of liver fibrosis in hepatitis B
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| 王小莉 |
| Thesis Advisor | 陈青锋
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| 2012-05-16
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 乙型肝炎
肝纤维化
血清学指标
无创诊断模型
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| Abstract | 目的：运用受试者工作特征曲线（ROC）评价血清学指标，并以其为基础建立诊断模型预测乙肝肝纤维化。
方法：选择2008.2-2011.11兰州大学第一医院住院及门诊治疗133例行肝活检的慢性乙型肝炎患者，将其随机分为模型组（n=89例）和验证组（n=44例），记录血常规、血生化、出凝血时间、乙肝三系统、HBV DNA、甲胎蛋白、血清蛋白电泳、肝纤维化4项等实验室检查结果。模型组，将有无显著纤维化（S0-S1、S2-S4）设为研究终点，采用ROC曲线评价各个指标的灵敏度（sensitivity）、特异度（specificity）及ROC曲线下面积（AUC），使用Logistic回归方程选择出与研究终点相关的独立预测因子，建立诊断模型。验证组中验证模型的诊断效能。
结果：血清AST是诊断肝纤维化的较优指标，它的AUC是0.753，敏感度和特异度分别为66%、88%。模型组，建立了由AST、GLB、DBIL构成的诊断模型，ROC曲线分析显示该模型在诊断显著纤维化的AUC是0.894，以积分2.91为界值，敏感性、特异性、准确性分别是53.33%、94.74%、83%。将该模型以同样标准用于验证组，其与模型组AUC比较差异无统计学意义，两组的诊断效率总体上接近。
结论：血清AST是诊断肝纤维化的较优指标。以AST、ALB、DBIL建立的诊断方程在诊断显著肝纤维时有较高的价值。 |
| Other Abstract | Objective:Using receiver operating characteristic curve to evaluate the serum markers,and establish a predictive model for liver fibrosis in hepatitis B based on those parameters.
Methods:133 cases chronic hepatitis B patients were selected.There were randomly divided into model group and validation group.Biochemical investigations etal were collected.In model group, sensitivity,specificity,AUC of those parameters were assessed by ROC. The model were builded by logistic regression equation. In validation group, the model were tested.
Results:AST is better indicator,AUC,sensitivity,specificity were 0.753, 66%, 88%. AST, ALB, DBIL were indentified by multivariate logistic regession analysis. In ROC analysis, the AUC was 0.894 for model group.When cutoff is 2.91,sensitivity,specificity,accuracy were 53.33%, 94.74%, 83%. There were no significant differences in diagnosis efficacy in the model and validation group.
Conclusion: AST is better indicator for diagnosis liver fibrosis. The model were significant diagnosis value in fibrosis. |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/222361
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
王小莉. 乙肝肝纤维化无创诊断模型的研究[D]. 兰州. 兰州大学,2012.
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