Evaluation of the diagnostic significance of calculated indices for determining the class of liver cirrhosis
https://doi.org/10.31146/1682-8658-ecg-203-7-31-37
Abstract
The aim. To evaluate the diagnostic characteristics of the calculated APRI indices and the liver cirrhosis classifier (CCP) to determine the class of liver cirrhosis. Materials and methods. The study involved 53 patients with cirrhosis of the liver of different etiologies (32 men and 21 women) with an average age of 53.2 ± 5.86 years, of which 22 people (41%) had an alcoholic genesis of the disease, 21 patients (40%) - viral (in the outcome of HCV), 10 patients (19%) had a mixed etiology of cirrhosis (alcohol + hepatitis C virus). The control group included 10 practically healthy individuals. The activity of aspartate aminotransferase (AST), the concentration of total bilirubin (OB), albumin, the number of platelets and the time of activated partial thromboplastin time (APTT) were determined in the blood. To assess the severity of the patients’ condition and the class of liver cirrhosis, the Child-Pugh classification was used, the presence and severity of ascites were determined by ultrasound. The APRI index was calculated using the formula: APRI = (AST / (upper limit of AST)) × 100 / platelets (109/l), where the upper normal AST value was 34 units/l. The CСР index was determined using the formula: CPR = 1.4328 + 0.0014 x AST + 0.00008 x ОВ x 0.0771 x ALBUMIN + 0.0721 x AРТТ. Results. With values of the APRI index less than 0.38 and the CСР index less than 0.5, cirrhosis with a sensitivity of 100% and a specificity of 80-90% is excluded. With an APRI value from 0.8 to 1.5 and a CСР from 0.5 to 1.4, patients are diagnosed with class A liver cirrhosis, the intervals of 1.5 ≤ APRI ≤ 2.0 and 1.5 ≤ CСР ≤ 2.4 correspond to class B cirrhosis, and the values of the APRI indices ≥2.0 and CСР ≥ 2.5 correspond to class C. Conclusion: the calculated APRI and CСР indices are minimally invasive, easy to perform, include a small list of inexpensive and affordable laboratory tests, have good diagnostic characteristics, therefore they can be used in clinical practice to exclude liver cirrhosis and objectively assess the severity of the disease in order to timely conduct adequate drug therapy in patients.
About the Authors
Irina A. Bulatova
Perm State Medical University n.a E. A. Wagner of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Tatiana P. Shevlyukova
Tyumen State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
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For citations:
Bulatova I.A., Shevlyukova T.P. Evaluation of the diagnostic significance of calculated indices for determining the class of liver cirrhosis. Experimental and Clinical Gastroenterology. 2022;(7):31-37. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-203-7-31-37
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