摘要
目的评价瞬时弹性成像对慢性乙型肝炎(CHB)合并非酒精性脂肪性肝病(NAFLD)肝纤维化的评估价值。方法选取2015年1月至2020年1月郑州市第六人民医院收治的CHB合并NAFLD患者144例(男98例、女46例),年龄(41.5±8.5)岁。计量资料比较采用独立t检验,计数资料比较采用卡方检验;MedCalc 15.1绘制ROC曲线,计算AUC,采用Z检验;Spearman相关分析探讨相关性;多元线性回归分析筛选独立预测因素并进行多元线性回归分析,建立回归模型。结果 CHB合并NAFLD患者肝脏硬度(LSM)值肝纤维化F0期(5.4±1.8)kPa,F1期(6.3±2.2)kPa,F2期(8.3±2.5)kPa,F3期(12.0±4.3)kPa,F4期(30.2±5.4)kPa,各肝纤维化分期之间差异具有统计学意义(P<0.05)。诊断F4期时AUC值显著高于≥F2期和≥F3期,差异均有统计学意义(P<0.05)。诊断F4期肝纤维化LSM截断点、敏感性、特异性及AUC分别为12.4 kPa、97%、90%及0.92。Spearman相关分析显示,年龄、AST、Alb、TBil、ALP、PLT、PT、HA、LN及CⅣ与肝纤维化分期呈显著相关性(P<0.05)。以LSM值为因变量,上述指标为自变量,进行多元线性回归分析。TBil(B=0.21,P<0.05)、Alb(B=-0.14,P<0.05)、PT(B=0.27,P<0.05)、CⅣ(B=0.17,P<0.05)为LSM值的独立预测因素,建立回归方程为Y(LSM)=-30.6+0.21×TBil-0.14×Alb+0.27×PT+0.17×CⅣ,回归模型方差分析F=16.248(P<0.05),回归模型具有统计学意义(P<0.05)。结论应用FibroScan检测LSM值对CHB合并NAFLD患者肝纤维化具有较高的诊断价值。
Objective To evaluate transient elastography in the evaluation of liver fibrosis in patients with chronic hepatitis B(CHB)complicated with non-alcoholic fatty liver disease(NAFLD).Methods A total of 144 patients with CHB complicated with NAFLD between January 2015 and January 2020 were selected.There were 98 males and 46 females with an average age of(41.5±8.5)years.The measurement data were compared by independent t-test,and the counting data were compared by chi-square test.The subjects’ working characteristic curve(ROC curve)was drawn by MedCalc 15.1 statistical software,and the area under the curve(AUC),was calculated by Z test.Spearman correlation analysis was used to compare the correlation between LSM and clinical data.The independent predictive factors are screened by multiple linear regression analysis,and the independent predictive factors are analyzed by multiple linear regression analysis,and the regression model is established.Results 144 patients with CHB complicated with NAFLD,there was significant difference among the stages of hepatic fibrosis in F0 stage,kPa,F1 stage,kPa,F2 stage,kPa,F3 stage,kPa,F4 stage and kPa,stage.The value of AUC in F4 stage was significantly higher than that in ≥ F2 stage and ≥ F3 stage,and the difference was statistically significant(P <0.05).The cutoff point,sensitivity,specificity and AUC of LSM for diagnosis of F4 liver fibrosis were 12.4 kPa,97%,90% and 0.92,respectively.Spearman correlation analysis showed that age,AST,Alb,TBil,ALP,PLT,PT,HA,LN,C Ⅳ were significantly correlated with the stage of liver fibrosis.Multiple linear regression analysis was carried out with the LSM value as the dependent variable and the above indexes as the independent variable.TBil,Alb,PT and C IV were independent predictors of LSM.The regression equation was Y(LSM)=-30.6+0.21×TBil-0.14×Alb+0.27×PT+0.17×CⅣ,and the regression model was statistically significant.Conclusion The detection of LSM by FibroScan is of high value in the diagnosis of liver fibrosis in patients with C
作者
冯少阳
李广明
苏航
FENG Shao-yang;LI Guang-ming;SU Hang(Department of Ultrasound,Zhengzhou Sixth People's Hospital.Henan 450000,China)
出处
《肝脏》
2021年第1期44-46,共3页
Chinese Hepatology
基金
郑州市科学技术局基金(189PKJHM0787)。
关键词
非酒精性脂肪性肝病
慢性乙型肝炎
肝纤维化
瞬时弹性成像
肝脏硬度值
Nonalcoholic fatty liver disease
Chronic hepatitis B
Liver fibrosis
Transient elastography
Liver stiffness measurement
