瞬时弹性成像仪检测肝脏硬度评价慢性乙型肝炎肝纤维化程度的影响因素分析

Analysis on the influence factors for liver fibrosis with chronic hepatitis B by Fibro Touch

目的探讨瞬时弹性成像仪检测肝脏硬度(LSM值)评价慢性乙型肝炎肝纤维化程度的相关影响因素。方法选取经肝组织穿刺活检确诊的慢性乙型肝炎病毒感染者144例,应用瞬时弹性成像仪检测肝脏LSM值,同时收集患者一般临床信息及实验室检查指标。将筛选出的自变量进行多元线性回归分析,建立回归方程,并对回归模型进行评估。结果本研究共筛选出6个独立预测因子,分别为脾脏肋间厚度、体质量指数、血清白蛋白、总胆红素、凝血酶原时间及Ⅳ型胶原;多元线程回归方程为Y(LSM)=-24.9+0.28X1+0.18X2+0.22X3-0.15X4+0.29X5+0.17X6,其中X1为脾脏肋间厚度,X2为体质量指数,X3为总胆红素,X4为血清白蛋白,X5为凝血酶原时间,X6为Ⅳ型胶原;决定系数R2=0.648,校正决定系数后调整R2=0.609。结论瞬时弹性成像检测LSM值时,脾脏肋间厚度、体质量指数、血清白蛋白、总胆红素、凝血酶原时间及Ⅳ型胶原均可能会对检测结果产生影响。

Objective To explore the related factors on the degree of liver fibrosis in patients with chronic hepatitis B by Fibro Touch detect liver stiffness(LSM value).Methods One hundred and forty four-patients with chronic hepatitis B confirmed by liver biopsy were included.The LSM value detected by Fibro Touch technique,the general clinical information and blood test were collected and analyzed.Multivariate linear regression analysis was performed to establish the regression equation,and the regression model was evaluated.Results The 6 independent predictors selected by multiple linear regression were as follows :spleen intercostals thickness,body mass index(BMI),serum albumin(ALB),total bilirubin(TBil),prothrombin time(PT),type Ⅳ collagen(CⅣ).The regression equation was Y(LSM)=-24.9+0.28 X1+0.18 X2+0.22 X3-0.15 X4+0.29 X5+0.17 X6,X1 was spleen intercostal thickness,X2 was BMI,X3 was TBil,X4 was ALB,X5 was PT,X6 was C Ⅳ.The regression model determination coefficient R^2=0.648,adjust R^2 =0.609.Conclusion When Fibro Scan is performed to detect LSM,spleen intercostals thickness,CⅣ,ALB,TBil,PT and BMI may have effect on the detection results.