التفاصيل البيبلوغرافية
| العنوان: |
Validity and Clinical Utility of the Aspartate Aminotransferase–Alanine Aminotransferase Ratio in Assessing Disease Severity and Prognosis in Patients With Hepatitis C Virus–Related Chronic Liver Disease. |
| المؤلفون: |
Giannini, Edoardo, Risso, Domenico, Botta, Federica, Chiarbonello, Bruno, Fasoli, Alberto, Malfatti, Federica, Romagnoli, Paola, Testa, Emanuela, Ceppa, Paola, Testa, Roberto |
| المصدر: |
Archives of Internal Medicine; 1/27/2003, Vol. 163 Issue 2, p218, 7p |
| مصطلحات موضوعية: |
LIVER disease diagnosis, AMINOTRANSFERASES, ASPARTATE aminotransferase, HEPATITIS C |
| مستخلص: |
Background: The aspartate aminotransferase–alanine aminotransferase ratio (AST/ALT ratio) has been used to noninvasively assess the severity of disease in patients with chronic liver disease (CLD). We previously demonstrated that progressive liver functional impairment is associated with an increase in the AST/ALT ratio. Objectives: To evaluate the reproducibility and transportability of the AST/ALT ratio in a large cohort of patients with different degrees of hepatitis C virus (HCV)–related CLD, to confirm the correlation between progressive impairment of liver function and increase in the AST/ALT ratio, to evaluate whether diagnostic accuracy of the ALT/AST ratio can be improved by using it with other biochemical variables, and to assess the 1-year prognostic capability of the AST/ALT ratio in patients with liver cirrhosis. Patients and Methods: We retrospectively evaluated 252 patients with HCV-related CLD. The AST/ALT ratio was correlated with the degree of liver fibrosis in patients with chronic hepatitis and with the Child-Pugh score in patients with cirrhosis. All patients had undergone monoethylglycinexylidide (MEGX) testing to evaluate liver function. We assessed the prognostic ability of the AST/ALT ratio in a subset of 63 cirrhotic patients who were followed up for at least 1 year. Results: The AST/ALT ratio was more frequently 1 or higher in cirrhotic patients (P<.001). There was a significant correlation between MEGX values and the AST/ALT ratio (r[sub s] = -0.621, P<.001). Multivariate stepwise logistic analysis showed that AST/ALT ratio, platelet count (PLT), MEGX values, and prothrombin activity were independently associated with the presence of cirrhosis. Combined assessment of the AST/ALT ratio and/or PLT obtained 97.0% positive predictive value and 97.9% negative predictive value for the diagnosis of cirrhosis. The AST/ALT ratio had 81.3% sensitivity and 55.3% specificity in identifying cirrhotic patients who died within 1-year... [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
