摘要
目的评价瞬时弹性扫描仪(FS)诊断慢性乙型肝炎肝纤维化的应用价值。方法选择2011年4—12月在石家庄市第五医院住院治疗的慢性乙型肝炎患者134例为研究对象,每例患者均在肝穿刺活检前1周内应用FS检测肝脏弹性测量值(LSM)。以肝穿刺活检结果为"金标准",并对肝纤维化程度进行分期。比较不同肝纤维化分期间LSM的差异,分析LSM与肝纤维化分期的关系,并采用受试者工作特征(ROC)曲线评价FS对慢性乙型肝炎肝纤维化的诊断价值。结果不同肝纤维化分期患者LSM比较,差异有统计学意义(F=91.464,P=0.000),且相邻分期间LSM比较,差异均有统计学意义(P<0.01)。Spearman等级相关分析显示,LSM与肝纤维化分期呈正相关(r=0.826,P<0.01)。绘制ROC曲线发现,FS诊断S1～S4期肝纤维化的ROC曲线下面积(AUROC)为0.92,灵敏度为0.94,特异度为0.90,临界值为4.60 kPa;诊断S2～S4期肝纤维化分别为0.93、0.88、0.85、7.60 kPa;诊断S3～S4期肝纤维化分别为0.97、0.94、0.91、9.40 kPa;诊断S4期肝纤维化分别为0.96、1.00、0.88、13.20 kPa。结论FS对乙型肝炎肝纤维化具有较好的诊断价值,为无创性检查方法,对于不能或不愿意进行肝穿刺活检的肝纤维化患者,FS是理想的选择,值得推广应用。
Objective To investigate the value of FibroScan for diagnosis of liver fibrosis in patients with chronic hepa- titis B （CHB）. Methods Totally 134 CHB patients between April and December 2011 in our hospital were enrolled in this study. All of them underwent liver stiffness measurement （LSM） by FibroScan before one week of liver biopsy. With liver biop- sy as the gold standard, the liver fibrosis was staged. The correlation between fibrosis stage and LSM was analyzed, and the re- ceive operating characteristic （ROC） curve was adopted to analyze the accuracy of FibroSean for diagnosing liver fibrosis. Re- stilts LSM showed significant difference among patients with different fibrosis stages （ F = 91. 464, P = 0. 000） ; Meanwhile, significant differences were also noted between the adjacent groups （P 〈0. 01 ）. Spearman correlation showed positive correlation （ r =0. 826, P 〈0. 01 ）. When FibroSean was applied for the assessment of liver fibrosis, the ROC area under the curve, sensi- tivity, specificity, and cut - off value were 0. 92, 0. 94, 0. 90, and 4. 60 kPa for the patients with S1 - S4, 0. 93, 0. 88, 0.85, and 7.60kPaforthosewith S2 -S4, 0.97, 0.94, 0.91, and 9. 40 kPa for those with S3 -S4, and0.96, 1.00, 0. 88, and 13.20 kPa for those with S4. Conclusion As a noninvasive approach, FibroScan is valuable for the diagnosis of liv- er fibrosis in CHB patients.
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第35期4068-4070,共3页
Chinese General Practice
基金
河北省卫生厅科研指令性课题(08189)
关键词
弹性成像技术
弹性测量值
肝炎
乙型
肝硬化
Elasticity imaging techniques
Liver stiffness measurement
Hepatitis B
Liver cirrhosis
