FibroScan用于慢性肝病患者肝纤维化的早期诊断价值

Application of FibroScan in early diagnosis of liver fibrosis in patients with chronic liver disease

目的总结FibroScan(瞬时弹性扫描仪)用于慢性肝病患者肝纤维化早期诊断的应用价值。方法选择我院2013年5月至2016年5月收治的90例慢性HBV感染者和慢性乙型肝炎患者作为研究对象,均行FibroScan检测,并以肝活检组织病理学检查结果为金标准。比较慢性HBV感染者与慢性乙型肝炎患者的Stiffness值(肝硬度值),以肝活检结果为基准计算慢性乙型肝炎患者的肝纤维化分期诊断符合率。记录S0~S4慢性乙型肝炎患者的Stiffness值,并与AST(谷草转氨酶)与ALT(谷丙转氨酶)水平进行比较。结果慢性乙型肝炎患者的Stiffness值为(10.53±3.43)k Pa,显著高于慢性HBV感染者(P<0.05)。不同肝纤维化分期的慢性乙型肝炎患者的AST、ALT两两对比均无统计学差异(P>0.05);随肝纤维化分期严重程度的增加,Stiffness值均升高,且不同分期的两两对比均有统计学差异(P<0.05)。FibroScan诊断出1例S1期经病理诊断为S0,FibroScan诊断1例S3,病理结果诊断为S4,诊断总体符合率为96.15%,与肝活检结果相比有很好的一致性(κ值=0.951)。结论利用FibroScan测定慢性肝病患者的Stiffness值对评估肝纤维化程度具有较大价值,且为无创、操作简便的检查手段,利于慢性肝病肝纤维化的早期诊断及治疗。

Objective To summarize the application value of FibroScan （instant elastic scanner） in early diagnosis of liver fibrosis in patients with chronic liver diseases. Methods Ninety outpatients and inpatients with chronic HBV infection or chronic hepatitis B admitted to our hospital from May 2013 to May 2016 were examined by FibroScan. The histopathological results of liver biopsy were taken as the golden standard. The stiffness value was compared between patients with chronic HBV infection and patients with chronic hepatitis B. The accordance rate of staging diagnosis of liver fibrosis in patients with chronic hepatitis B was calculated based on the results of liver biopsy. Stiffness values （liver stiffness value） of patients with S0~S4 chronic hep-atitis B were recorded and compared with AST （aspertate aminotransferase） and ALT （alanine transaminase） levels. Results The mean stiffness value of patients with chronic hepatitis B was significantly higher than pa-tients with chronic HBV infection （P〈0.05）. There were no significant differences in AST and ALT between any paired comparison of patients with chronic hepatitis B at different liver fibrosis stages （P〉0.05）;With the increase of liver fibrosis stage, stiffness values increased, and there were significant differences between differ-ent stages （P〈0.05）. In the FibroScan diagnosed S1, 1 cases were pathologically diagnosed as S0, and 1 cases were pathologically diagnosis as S3 by stage. The overall rate of compliance was 96.15%. Compared with liver biopsy, the Kappa consistency test was 0.951. Conclusion Stiffness values of patients with chronic liver dis-ease determined by FibroScan is of relatively higher value in evaluating the degree of hepatic fibrosis, and it is noninvasive, and simple to operate, which is conducive to the early diagnosis and treatment of liver fibrosis in chronic liver disease.