Fibrotouch联合FIB-4指数对肝硬化患者发生并发症的预测价值

Predictive value of Fibrotouch combined with FIB-4 index in prediction of complications in patients with liver cirrhosis

目的评价Fibrotouch联合FIB-4指数对肝硬化患者发生并发症的预测价值。方法 2015年6月~2016年2月我院诊治的肝硬化患者,使用Fibrotouch测量其肝脏硬度值(LSM),计算其FIB-4指数。比较不同Child-Pugh分级患者、代偿期与失代偿期肝硬化患者、单一并发症与多种并发症肝硬化患者LSM和FIB-4指数差异。采用Logistic回归分析进行风险预测,应用受试者工作特征曲线(ROC)评价诊断试验的效能。结果Child-Pugh A级患者LSM为(17.09±7.15)kPa,显著低于Child-Pugh B级【(27.37±5.83)kPa,P<0.01】或Child-Pugh C级【(34.26±9.10)kPa,P<0.01】患者;Child-Pugh A级患者FIB-4指数为(3.69±2.66),显著低于Child-Pugh B级【(6.67±4.30),P<0.01】或Child-Pugh C级【(8.49±4.69),P<0.01】;代偿期肝硬化患者LSM为(17.14±7.27)Kpa,显著低于失代偿期肝硬化患者【(29.11±7.79)kPa,P<0.01】;代偿期肝硬化患者FIB-4指数为(3.66±2.70),显著低于失代偿期肝硬化患者【(7.14±4.44),P<0.01】;单一并发症组LSM为(26.98±6.03)kPa,显著低于多种并发症组【(34.95±9.12)kPa,P<0.01】;单一并发症组FIB-4指数为(6.56±4.22),显著低于多种并发症组【(8.74±4.72),P<0.01】;Fibrotouch和FIB-4指数联合预测肝硬化并发症的AUC为0.903,显著高于FIB-4指数单独预测时的AUC(0.765,P<0.01)。结论 Fibrotouch与FIB-4指数联合对肝硬化患者发生并发症的预测价值较高,值得进一步研究。

Objective To evaluate the predictive value of complications by Fibrotouch combined with FIB-4 index in patients with liver cirrhosis. Methods Between June 2015 and February 2016, the patients with liver cirrhosis in our hospital were recruited in this study. Fibrotouch was applied to detect the liver stiffness measurement （LSM）,and FIB--4 index was calculated. The differences in LSM and FIB-4 index among patients with different Child-Pugh class,patients with compensated or decompensated cirrhosis and patients with single complications or multiple complications were analyzed. Logistic analysis was used to predict the risk for occurrence of complications, and receiver operating characteristic curves were used to evaluate its predictive value. Results The LSM in patients with Child-Pugh class A was （17.09±7.15） kPa,significantly lower than that in with Child-Pugh class B [（27.37±5.83）kPa,P〈0.01] or that in with Child-Pugh class C[（34.26±9.10） kPa,P〈O.01]; the FIB-4 index in patients with Child-Pugh class A was（3.69±2.66）,significantly lower than that in with Child- Pugh class B [（6.67±4.30）,P〈0.01] or that in with Child-Pugh class C [（8.49±4.69）,P〈0.01];The LSM in compensated cirrhosis patients was （17.14±7.27）kPa,significantly lower than that in the decompensated cirrhosis patients [（29.11±7.79）kPa,P〈0.01];the FIB--4 index in compensated cirrhosis patients was （3.66±2.70）, significantly lower than that in the decompensated cirrhosis patients [（7.14±4.44）,P〈0.01l;The LSM in patients with single complication was （26.98 ±6.03） kPa,significantly lower than that in with multiple complications [（34.95±9.12）kPa,P〈0.01];the FIB-4 index in single complication patients was （6.56±4.22）,significantly lower than that in multiple complications patients r（8.74±4.72）,P〈0.01];The AUC of Fibrotouch combined with FIB-4 index to predict complications in patients with liver cirrhosis was 0.903,significantly higher than that by FIB-4 index alone（ 0.765,P〈0.01）. Conclusion Fibrotouch combined with FIB-4 index can improve the predictive value of complications in patients with liver cirrhosis,which is worthy of clinical application.