[Study on heme oxygenase-1 and HAP model for the diagnosis of chronic hepatitis B-related liver fibrosis]

Objective: To determine the diagnostic value of plasma heme oxygenase 1 (HO-1) in the occurrence, development, and pathological stages of chronic hepatitis B-related liver fibrosis. Methods: 211 outpatients and inpatients with chronic hepatitis B (CHB) and 57 healthy controls who visited the Third Hospital of Hebei Medical University were selected. Simultaneously, clinical data, peripheral blood routine and serum biochemical test results of the research subjects were collected. Plasma HO-1 levels were detected by enzyme-linked immunosorbent assay (ELISA). Liver fibrosis (S1 ~ 4) was staged according to liver biopsy and liver stiffness measurement (LSM). Statistical analysis: binary logistic regression was used to analyze the independent risk factors of hepatitis B-related liver fibrosis to establish a diagnostic model, and the receiver operating characteristic curve (ROC) was used to compare and analyze the staging efficiency of HO-1, new model, FIB-4 and APRI for the diagnosis of liver fibrosis. Results: Plasma HO-1 levels were significantly higher in CHB patients than healthy controls [10.11 (7.08 ~ 13.12) ng/ml and 6.71 (5.56 ~ 8.45) ng/ml, ( P < 0.001)]. There were 37, 38, 38, and 98 cases with liver fibrosis stages S1, S2, S3, and S4, respectively and plasma HO-1 level was (6.91 ± 2.80) ng/ml, (8.24 ± 2.44) ng/ml, (9.96 ± 3.46) ng/ml, (12.65 ± 3.70) ng/ml, P < 0.001. HO-1, albumin, and platelets (PLT) were independent risk factors for liver fibrosis. A HAP model was established. HAP, FIB-4 and APRI sensitivity and specificity for the diagnosis of liver fibrosis staging were as follows: ≥S2 were 84.62%, 72.35 %, 81.18% and 83.78%, 81.08%, 67.57%; ≥S3 were 80.15%, 82.09%, 85.82% and 88.64%, 76.19%, 60.32%; S4 were 90.82%, 82.29%, 86.46% and 74.37%, 65.77%, 48.65%, respectively. Conclusion: Plasma HO-1 level can reflect the severity of liver fibrosis. HAP diagnostic model can more accurately mirror the process of liver fibrosis than FIB-4 and APRI, and point clinical diagnosis and prognosis assessment.