Factor analysis and risk prediction model construction of clinical disease progression in hepatitis B e antigens-negative chronic hepatitis B cirrhosis
10.3760/cma.j.cn115455-20240808-00689
- VernacularTitle:乙型肝炎e抗原阴性慢性乙型肝炎肝硬化临床疾病进展的因素分析及风险预测模型构建
- Author:
Wei LIU
1
;
Haikun LIANG
1
;
Li LI
1
Author Information
1. 邯郸市传染病医院检验科，邯郸 056000
- Publication Type:Journal Article
- Keywords:
Hepatitis B e antigens;
Hepatitis B;
Liver cirrhosis;
Disease progression;
Risk factors
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(8):724-729
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the factors of clinical disease progression in patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) cirrhosis, and to construct a risk prediction model.Methods:A total of 395 HBeAg-negative CHB cirrhosis patients admitted to Handan Infectious Disease Hospital from March 2018 to December 2023 were retrospectively selected, and disease progression (follow-up up to February 2024) was taken as the end event. Among them, 113 patients developed disease progression (progression group) and 282 patients did not develop disease progression (non-progression group). Univariate and multivariate Logistic regression were used to analyze the risk factors for clinical disease progression in patients with HBeAg-negative CHB cirrhosis, and a nomogram risk prediction model was constructed. Calibration curve, receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to verify the efficacy of the model.Results:The results of single factor analysis showed that age, family history of liver disease, alcohol consumption history, Child-Pugh rating, hypertension, model of end-stage liver disease (MELD) score, portal vein diameter, hepatitis B virus-DNA (HBV-DNA) measurement, albumin (ALB), spleen vein diameter, total bilirubin (TBIL), blood sodium, hemoglobin (Hb), blood ammonia, and white blood cell count (WBC), international normalized ratio (INR), liver stiffness measurement (LSM) and C-reactive protein (CRP) were the factors that affected clinical disease progression ( P<0.05). Logistic regression analysis showed that drinking history, Child-Pugh grade, MELD score, portal vein diameter, HBV-DNA quantification, splenic vein diameter, LSM, ALB, Hb and CRP were independent risk factors affecting clinical disease progression ( OR = 3.537, 6.407, 1.554, 1.658, 8.090, 1.681, 1.539, 0.382, 0.232, 1.924, P<0.05). The calibration curve showed that the prediction ability of the model was high, the ROC curve showed that the area under the curve (AUC) predicted by the model was 0.869 - 0.941, and the result of the DCA showed that the model had a high positive benefit. Conclusions:The influencing factors of clinical disease progression in HBeAg-negative CHB cirrhosis patients include alcohol consumption history, Child-Pugh grade, MELD score, portal vein diameter, HBV-DNA quantification, splenic vein diameter, LSM value, ALB, Hb and CRP. The risk early warning model based on the above factors has good predictive efficacy and clinical application efficacy.
