摘要
目的:观察瞬时弹性超声成像(Fibroscan)测定慢性乙型肝炎患者肝硬度值与肝组织活检病理学分期的相关性。方法:选取2016年1月至2018年1月我院收治的196例慢性乙型肝炎病例作为本次研究对象,均接受肝穿刺活检,确定肝纤维化分期,并以Fibroscan检测患者肝硬度值(Liver stiffness Measurement,LSM),分析LSM与肝纤维化分期相关性。结果:Fibroscan检测LSM分期S0灵敏度为92.31%(12/13),特异度100.00%(183/183),准确性99.49%(195/196),Kappa值为0.96;S1灵敏度为100.00%(54/54),特异度97.18%(138/142),准确性97.96%(192/196),Kappa值为0.95;S2灵敏度为97.18%(69/71),特异度99.20%(124/125),准确性98.47%(193/196),Kappa值为0.97;S3灵敏度为93.33%(42/45),特异度100.00%(151/151),准确性98.47%(193/196),Kappa值为0.96;S4灵敏度为92.31%(12/13),特异度98.91%(181/183),准确性98.48%(193/196),Kappa值为0.88;轻度纤维化组ALT、AST水平、Knodell评分及LSM明显低于中重度纤维化组(P<0.05);Fibroscan检测的LSM为肝组织活检病理学分期独立危险因素(P<0.05),其与Knodell评分、肝组织活检病理学分期呈正相关性(P<0.05)。结论:Fibroscan测定慢性乙型肝炎患者LSM,可为肝纤维化分期的评估提供参考,代替部分肝组织活检,对早期诊断肝硬化具有重要价值。
Objective:To observe the correlation between liver stiffness measured by transient elastography(Fibroscan)and liver biopsy pathological stage of patients with chronic hepatitis B.Methods:196 cases of patients with chronic hepatitis B who were admitted to the hospital from January 2016 to January 2018 were selected as the subjects.All patients underwent liver biopsy to determine the stage of liver fibrosis,and Fibroscan was used for liver stiffness measurement(LSM).The correlation of LSM with liver fibrosis was analyzed.Results:The sensitivity,specificity,accuracy and Kappa value of Fibroscan in detecting LSM stage S0 were 92.31%(12/13),100.00%(183/183),99.49%(195/196)and 0.96,respectively.For S1,the sensitivity,specificity,accuracy and Kappa value were 100.00%(54/54),97.18%(138/142),97.96%(192/196)and 0.95,respectively.Those for S2 were 97.18%(69/71),99.20%(124/125),98.47%(193/196)and 0.97,respectively,for S3 were 93.33%(42/45),100.00%(151/151),98.47%(193/196)and 0.96,respectively,and for S4 were 92.31%(12/13),98.91%(181/183),98.48%(193/196)and 0.88,respectively.Levels of ALT,AST,Knodell score and LSM were significantly lower in the mild fibrosis group than in the moderate and severe fibrosis group(P<0.05).The LSM measured by Fibroscan was an independent risk factor for liver biopsy pathological stage(P<0.05),and it was positively correlated with Knodell score and liver biopsy pathological stage(P<0.05).Conclusion:Fibroscan can be used as a reference for evaluating the stage of liver fibrosis.Instead of partial liver biopsy,it is of great value for early diagnosis of liver cirrhosis.
作者
曹发明
张照如
王翔
CAO Faming;ZHANG Zhaoru;WANG Xiang(Chaohu Hospital Affiliated to Medical University;Anhui Chaohu 238000,China)
出处
《河北医学》
CAS
2018年第7期1223-1226,共4页
Hebei Medicine
基金
安徽省科技计划项目
(编号:2013B03105241)
