Fibroscan对慢性乙型肝炎肝脏纤维化的诊断研究

Diagnostic study of Fibroscan for liver fibrosis in patients with chronic hepatitis B

目的探讨肝脏瞬时弹性成像系统(FS)对慢性乙型肝炎肝脏纤维化的诊断意义。方法随机选取本院162例慢性乙型肝炎患者分别行FS值检测,受试者同期行肝穿刺活检。以肝活检的不同分级结果为判断界点构建FS的ROC曲线,计算曲线下面积(AUC)、阳性和阴性结果的临界值(cut-off值),评价FS对慢性乙型肝炎肝脏纤维化的诊断意义。结果 FS对显著纤维化(S2-S4)、严重纤维化(S3-S4)、早期肝硬化(S4)的AUC值分别为0.81、0.88、0.90,cut-off值分别为7.3、9.7、17.5 KPa;随着肝功能受损程度的加重,胆红素、转氨酶的升高对FS值的影响差异有统计学意义。结论 Fibroscan对慢性乙型肝炎肝脏纤维化的诊断分析有较高的临床价值,对肝硬化、严重纤维化、显著纤维化(S≥2)的诊断价值优于轻度肝纤维化(S<2)。

Objective To explore the clinical application value of Fibroscan （FS） in the diagnosis of liver fibrosis in patients with chronic hepatitis B virus. Methods 162 patients with chronic hepatitis B virus were enrolled randomly and performed FS and underwent liver biopsy. With the different classification results of liver biopsy, ROC curve were delineated for different endpoints; the area under the ROC curves （AUC） and cut-off values were used to evaluate the diagnostic significance for liver fibrosis in patients with chronic hepatitis B. Results The AUC values of Fibroscan of obvious fibrosis （S2-S4）, severe fibrosis （S3-S4） and early cirrhosis （S4） were 0.81, 0.88 and 0.90, respectively, and the cut-off values were 7.3,9.7 and 17.5 KPa,respectively. With the deteriotation of the liver function, the increases in bilirubin and transaminase were significantly affected the FS value. Conclusions Fibroscan has a better clinical application value in the diagnosis of liver fibrosis in patients with chronic hepatitis B. The diagnostic values for cirrhosis, extensive fibrosis and significant fibrosis were more significant than that for mild liver fibrosis（S〈2）.