瞬时弹性记录仪Fibroscan在慢性乙型肝炎肝纤维化中的应用价值

Validation of transient elastography(Fibroscan) in assessment of hepatic fibrosis in chronic hepatitis B

目的:探讨瞬时弹性记录仪(FibroScan)对慢性乙型肝炎肝纤维化的临床应用价值。方法:对134例慢性乙型肝炎患者行FibroScan检查,将所检测到的肝硬度值与按照Scheuer系统进行肝组织活检纤维化分级的结果进行比较,用Spearman等级相关系数方法进行统计学分析。结果:134例慢性乙型肝炎患者中,S0期10例、S1期16例、S2期24例、S3期30例、S4期54例。除1例患者因肥胖导致瞬时弹性超声检测失败以外,其余均顺利受检。133例患者的瞬时弹性超声硬度值与其肝纤维化分期有显著相关性(r=0.905,P<0.01)。轻、中度纤维化组(S0、S1、S2期)与重度纤维化组(S3、S4期)的瞬时弹性超声硬度值相比,t=-16.671,P<0.01,差异有统计学意义。结论:FibroScan可以较准确地估计慢性乙型肝炎患者的纤维化程度,在乙型肝炎纤维化程度的长期随访与疗效评估中有着较好的应用价值。

Objective To validate transient elastography（Fibroscan） in assessment of hepatic fibrosis in chronic hepatitis B. Methods Liver stiffness was assessed using Fibroscan in totally 134 patients with chronic hepatitis B. The results by Fibroscan were compared with those by the Scheuer fibrosis stage in liver biopsy for each patient. Results There were10 patients shown as liver fibrosis stage S0, 16 as S1, 24 as S2, 30 as S3 and 54 as S4. One patient suffering from obesity failed to be detected, and the rest were successfully tested. The stiffness of Fibroscan was significantly correlated with the liver biopsy fibrosis stage（r=0.905, P〈0.01）. The liver stiffnesses between mild and moderate fibrosis（S0-2）and advanced fibrosis（S3-4） were significantly different（t=-16.671, P〈0.01）. Conclusion FibroScan can accurately estimate the extent of fibrosis in patients with chronic hepatitis B, and has a good application value in assessment of hepatic fibrosis in chronic hepatitis B.