摘要
目的:探讨超声瞬时弹性成像(FS)对慢性乙型肝炎患者肝纤维化的评估价值。方法:选取河南中医药大学第一附属医院2018年1月至2020年6月收治的80例慢性乙型肝炎患者作为研究对象,所有患者均接受肝脏穿刺活检,根据穿刺活检结果将患者分为五组,分别为S0组(24例)、S1组(21例)、S2组(15例)、S3组(9例)、S4组(11例),并对所有研究对象行FS检测肝脏硬度(LSM)值。比较五组患者LSM值差异,通过Spearman相关分析LSM值与肝纤维化分期的相关性,采用受试者工作特征曲线(ROC)分析LSM值对肝纤维化程度的诊断价值。结果:(1)LSM值随肝纤维化分期的增加而上升(F=128.98,P<0.001)。(2)Spearman相关分析结果显示,LSM值与肝纤维化病理分期呈高度正相关(r=0.704,P<0.001)。(3)ROC曲线分析显示,LSM值诊断≥S1期患者的约登指数(0.551)最大时对应截断值为6.76 kPa,曲线下面积为0.850,诊断灵敏度为78.38 %,特异度为76.74 %;LSM值诊断≥S2期患者的约登指数(0.716)最大时对应截断值为9.61 kPa,曲线下面积为0.875,诊断灵敏度为88.24 %,特异度为83.33 %;LSM值诊断≥S3期患者的约登指数(0.705)最大时对应截断值为11.34 kPa,曲线下面积为0.890,诊断灵敏度为90.48 %,特异度为80.00 %;LSM值诊断S4期患者的约登指数(0.755)最大时对应截断值为14.30 kPa,曲线下面积为0.902,诊断灵敏度为84.62 %,特异度为90.91 %。结论:FS检测能够准确反映慢性乙型肝炎患者肝纤维化程度。
Objective To evaluated the value of ultrasonic transient elastography (Fibroscan,FS) for hepatic fibrosis in patients with chronic hepatitis B.Methods A total of 80 patients with chronic hepatic B admitted to the First Affiliated Hospital of Henan University of Chinese Medicine from January 2018 to June 2020 were selected as the research subjects.All patients received hepatic biopsy and were divided into five groups according to the results of needle biopsy.The patients were S0 group (24 cases),S1 group (21 cases),S2 group (15 cases),S3 group (9 cases) and S4 group (11 cases),and the liver stiffness measurement (LSM) value of all subjects was detected by FS.The LSM values of the five groups were compared.Spearman correlation analysis was conducted to analyze the correlation between LSM values and hepatic fibrosis stage,and receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of LSM values for hepatic fibrosis degree.Results (1) LSM value increased with the increase of hepatic fibrosis stage (F=128.98,P < 0.001).(2) Spearman correlation analysis showed that LSM value was highly positively correlated with pathological stage of liver fibrosis (R=0.704,P < 0.001).(3) ROC curve analysis showed that the maximum cut-off value of the Youden index (0.551) was 6.76 kPa,the area under the curve was 0.850,the diagnostic sensitivity was 78.38%,and the specificity was 76.74% for patients with LSM diagnosis ≥ S1 stage.The maximum cut-off value of the Youden index (0.716) was 9.61 kPa,the area under the curve was 0.875,the diagnostic sensitivity was 88.24 %,the specificity was 83.33 % for patients with LSM diagnosis ≥ S2 stage.The maximum cut-off value of the Youden index (0.705) was 11.34 kPa,the area under the curve was 0.890,the diagnostic sensitivity was 90.48 %,and the specificity was 80.00 % for patients with LSM diagnosis ≥ S3 stage.The maximum cut-off value of the Youden index (0.755) for LSM diagnosis was 14.30 kPa,the area under the curve was 0.902,the diagnostic sensitivity was
作者
陈银玲
李超
张小东
CHEN Yin-ling;LI Chao;ZHANG Xiao-dong(The First Affiliated Hospital of Henan University of Chinese Medicine,Henan Zhengzhou 450000)
出处
《深圳中西医结合杂志》
2022年第10期65-68,共4页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
关键词
慢性乙型肝炎
超声瞬时弹性成像
肝纤维化
Chronic hepatitis B
Ultrasonic transient elastography
Hepatic fibrosis
