摘要
目的探讨肝脏瞬时弹性超声（Fibroscan）对于丙氨酸氨基转移酶（ALT）小于2倍正常值上限（upper limits of normal,ULN）的慢性乙型肝炎病毒（HBV）感染者肝纤维化的诊断价值,并分析影响因素。方法 125例ALT〈2 ULN的慢性HBV感染者,采用肝脏瞬时弹性超声测定不同肝脏纤维化分期组间以及不同炎症分级组间患者肝脏硬度值（liver stiffness measurement,LSM）,并进一步探讨年龄、性别、BMI、血清ALT、AST、TBIL、ALB、HBV-DNA与LSM值的相关性。结果 125例患者肝组织的纤维化分期在S0-S3期,炎症分级在G1-G3期。不同分期组间LSM值比较差异有统计学意义（P〈0.05）,但S0组和S1组比较差异无统计学意义;不同分级组间LSM值比较差异有统计学意义（P〈0.05）。经Spearman相关分析结果显示,患者的年龄、血清ALT及AST水平与LSM值呈正相关（P〈0.05）。男性患者的LSM值明显高于女性患者。结论 Fibroscan对于ALT〈2 ULN的慢性HBV感染者肝纤维化的无创诊断同样具有较好适用性。对于这部分人群,患者的性别、年龄、肝脏炎症程度,以及血清ALT、AST水平,是可能的Fibroscan测值影响因素。
Objective To explore the diagnostic value of fibroscan for liver fibrosis in patients with chronic hepatitis B virus（ HBV） infection whose alanine aminotransferase（ ALT） ALT levels were less than two-time up limit of normal（ ULN）,and analyze the factors affecting the fibroscan results. Methods The liver stiffness measurement（ LSM） was detected by fibroscan in 125 patients,and the results were compared with different liver inflammation groups and different liver fibrosis groups. Then,the correlations between LSM and age,gender,BMI,serum ALT,AST,TBIL,ALB and HBV-DNA were evaluated by using spearman＇s rank correlation analysis. Results In the 125 patients,the stages of liver fibrosis were S0 to S3,while the grades of liver inflammation were G1 to G3. However,there was no significant difference between the S0 and S1 groups. Spearman＇s rank correlation analysis showed that LSM and age,ALT and AST were positively correlated（ P〈0. 05）. In addition,the LSM values in male patients were obviously greater than that in female patients. Conclusion Fibroscan has a good clinical application value in diagnosis of liver fibrosis in patients with chronic HBV infection whose ALT level less than 2 ULN. For these patients,gender,age,liver inflammation,serum levels of ALT and AST may be the possible factors affecting the fibroscan results.
出处
《实用医院临床杂志》
2015年第2期34-36,共3页
Practical Journal of Clinical Medicine
