比较ARFI与APRI指数评估慢性丙肝肝纤维化程度的准确性

Accuracy Comparison between ARFI and APRI Index for Quantitative Evaluating Liver Fibrosis Degree in Chronic Hepatitis C Patients

目的比较辐射力脉冲成像技术(ARFI)和天门冬氨酸氨基转移酶(AST)与血小板(PLT)的比值(APRI指数)评估慢性丙肝肝纤维化程度的准确性。方法使用ARFI技术检查128例慢性丙型肝炎患者,并计算所有患者的APRI指数。根据病理结果分析和比较ARFI测值和APRI指数对慢性丙型肝炎肝纤维化的诊断价值,以及慢性丙肝患者肝纤维化程度与ARFI测量值和APRI指数的相关性。结果 ARFI(r=0.649,P<0.05)与肝纤维化分期存在正相关且相关性比APRI(r=0.478,P<0.05)更好。ARFI和APRI诊断慢性丙型肝炎肝纤维化≥S_2的ROC曲线下面积分别为0.775、0.721;≥S_3的曲线下面积分别为0.901、0.787;=S_4的曲线下面积分别为0.792、0.780。结论 ARFI技术比APRI指数能更准确地定量评价慢性丙肝患者的肝纤维化程度,具有良好的临床应用前景。

Objective To compare the accuracy of the acoustic radiation force impulse （ARFI） and AST/PLT ratio index （APRI） for the assessment of the liver fibrosis in chronic hepatitis C patients. Methods Totally 128 patients with chronic hepatitis C were investigated through the acoustic radiation force impulse （ARFI） technology, and the APRI was calculated. Referring to the pathological examination, all the ARFI and the APRI value were analyzed and compared. The correlation of the liver fibrosis in chronic hepatitis C and the ARFI technology and APRI index were assessed. Results ARFI （r = 0. 649, P 〈 0.05） had a better correlation with liver fibrosis stage in chronic hepatitis C than APRI （ r = 0. 478, P 〈 0.05 ）. The areas under the ROC curves for ARFI and APRI were 0. 775 and 0. 721 for ≥ S2 , 0. 901 and 0. 787 for ≥ S3 , 0. 792 and 0. 780 for = S4 , respectively. Conclusion ARFI is more accurate while being applied to evaluate liver fibrosis in patients with chronic hepatitis C than APRI.