摘要
目的探讨肝脏硬度(LSM)值、天门冬氨酸氨基转移酶/血小板比率指数(APRI)、基于4因子的肝纤维化指数(FIB-4)对儿童肝病肝纤维化的诊断价值。方法选取2020年9月至2021年11月江西省赣州市妇幼保健院收治的90例肝病患儿作为研究对象,按纤维化程度分为轻度肝纤维化组(52例)与重度纤维化组(38例)。检测两组患儿的LSM,通过血清学诊断模型计算出APRI、FIB-4。通过受试者工作特征(ROC)曲线分析计算LSM、APRI、FIB-4临界值、ROC曲线下面积,评估LSM、APRI、FIB-4对各组肝脏疾病肝硬化的诊断价值,并对LSM值与APRI、FIB-4的关系进行相关性分析。结果重度肝纤维化组患儿的LSM值、APRI、FIB-4水平高于轻度肝纤维化组,差异有统计学意义(P<0.05)。ROC分析结果显示,LSM值、APRI、FIB-4诊断肝纤维化的截断值分别为8.355、0.975、0.075,曲线下面积分别为0.923、0.934、0.952,联合诊断曲线下面积高于单独诊断。相关性分析显示,LSM值与APRI(r=0.673,P<0.001)、FIB-4(r=0.582,P<0.001)呈正相关。结论LSM值、APRI、FIB-4对儿童肝病肝纤维化具有诊断价值。
Objective To explore the diagnostic value of liver stiffness measurement(LSM),aspartate aminotransferase-to-platelet ratio index(APRI)and liver fibrosis index based on 4 factors(FIB-4)in children with liver fibrosis.Methods A total of 90 children with liver disease treated in Ganzhou Maternal and Child Health Hospital of Jiangxi Province from September 2020 to November 2021 were selected as the research objects.According to the degree of fibrosis,they were divided into the mild liver fibrosis group(52 cases)and the severe liver fibrosis group(38 cases).The LSM of the children was detected,and APRI and FIB-4 were calculated through the serological diagnostic model.The critical values of LSM,APRI,FIB-4 and the area under the receiver operating characteristic(ROC)curve were calculated by analyzing the ROC.The diagnostic value of LSM,APRI and FIB-4 for liver disease cirrhosis in each group were evaluated,and the correlation between LSM and APRI and FIB-4 were analyzed.Results The LSM,APRI and FIB-4 levels in the severe hepatic fibrosis group were higher than those in the mild hepatic fibrosis group,the differences were statistically significant(P<0.05).The ROC analysis results showed that the cut-off values of LSM,APRI and FIB-4 for the diagnosis of liver fibrosis were 8.355,0.975 and 0.075 respectively,and the area under the curve was 0.923,0.934 and 0.952 respectively.The area under the curve of combined diagnosis was higher than that of single diagnosis.Correlation analysis showed that LSM were positively correlated with APRI(r=0.673,P<0.001)and FIB-4(r=0.582,P<0.001).Conclusion LSM,APRI and FIB-4 are valuable in the diagnosis of hepatic fibrosis in children with liver diseases.
作者
黄亮
郑世燕
HUANG Liang;ZHENG Shiyan(Department of Pediatrics,Ganzhou Maternal and Child Health Hospital,Jiangxi Province,Ganzhou 341000,China)
出处
《中国当代医药》
CAS
2022年第32期46-48,57,共4页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(202212331)。
