瞬时弹性成像联合APRI及HA在慢性乙肝患者肝纤维化无创诊断中的应用

Application of FibroScan combined with APRI and HA for liver fibrosis in patients with chronic hepatitis B

目的探讨瞬时弹性成像技术(FibroScan)、谷草转氨酶/血小板(APRI)及透明质酸(HA)在慢性乙型肝炎患者肝纤维化诊断中的价值。方法比较分析符合条件的250例慢性乙肝肝炎患者肝硬度、APRI、HA单项及联合诊断模型对肝纤维化诊断效果,并分别绘制ROC曲线。结果肝硬度、APRI、HA单项及三项联合对S2~S4期肝纤维化诊断的曲线下面积分别为0.73、0.71、0.51及0.78;对S3~S4期的患者曲线下面积分别为0.79、0.62、0.78及0.85;对S4期的患者曲线下面积分别为0.81、0.52、0.75及0.81。结论肝硬度、APRI、HA三项指标联合可提高各期慢性乙型肝炎患者肝纤维化诊断效果,在肝纤维化的动态监测上有一定的临床应用价值。

Objective To investigate the value of transient elastography （ FibroScan）, APRI and hyalurenic acid （HA） in the diagnosis of liver fibrosis among patients with chronic hepatitis B. Methods Compare and analyze the single and combined diagnostic value of FibroScan, HA and APRI of 250 eligible patients, and draw the ROC curves respectively. Results The area under the curve of FibreScan, APRI, HA single and combined model in the diagnosis of S2-S4 stage of liver fibrosis were 0. 73, 0.71,0. 51 and 0.78, respectively; ForS3-S4 stage, these value were 0. 79, 0. 62,0. 78, 0. 85 and for S4 stage which were 0. 81,0. 52, 0.75 and 0. 81. Conclusions FibroScan combined with HA and APRI can improve the diagnostic value of liver fibrosis in all stage among patients with chronic hepatitis B, and it can be applied in dynamic monitoring of liver fibrosis.