FibroTouch在慢性肝病中临床的应用及与多参数模型的比较

Clinical application of FibroTouch in chronic liver disease and its comparison with multiparameter model

目的评估瞬时弹性超声成像仪(FibroTouch)与多参数模型在慢性肝病患者肝脏纤维化诊断中的临床应用价值及FibroTouch诊断肝纤维化分期的最佳诊断截点(cutoff)值。方法 2014年1月至2016年10月该院慢性肝病患者进行肝脏组织活检48例,收集血常规、肝功能等血清学指标,同时应用FibroTouch进行肝脏弹性测量值(LSM)测量,分析LSM与肝脏纤维化的相关性,cutoff值与APRI、FIB-4、FibroIndex多参数模型诊断效能的比较。结果以肝脏穿刺病理结果为金标准,Spearman等级相关性分析提示LSM、APRI、FIB-4、FibroIndex多参数模型与肝纤维化相关(P<0.05)。受试者工作特性曲线(ROC)分析,F1~F4期FibroTouch诊断肝纤维化分期的最佳cutoff值依次为6.6、7.7、10.5、15kPA;诊断有无显著纤维化和肝硬化时的诊断价值优于APRI、FIB-4、FibroIndex多参数模型。结论 FibroTouch在评估慢性肝病患者肝脏纤维化程度有较高的临床应用价值。

Objective To evaluate the clinical application value of instantaneous elastic ultrasonic imaging（FibroTouch）and multiparameter model in the liver fibrosis diagnosis of the patients with chronic liver disease,and to determine the best diagnostic cutoff point value of liver fibrosis stage diagnosed by FibroTouch.Methods Forty-eight cases of chronic liver disease conducted the liver tissue biopsy.The serological indexes of blood routine and liver function were collected.At the same time the liver stiffness measurement（LSM）was performed by using FibroTouch.The correlation between LSM and liver fibrosis was analyzed.The diagnostic efficiencies were compared between cutoff value with APRI,FIB-4 and FibroIndex multiparameter model.Results The liver puncture pathological results served as the gold standard.The Spearman rank correlation analysis showed that LSM,APRI,FIB-4 and FibroIndex multiparameter model were correlated with liver fibrosis（P〈0.05）.In the receiver operating characteristic（ROC）curve analysis,the cutoff values of stage F1~F4 were in turn 6.6,7.7,10.5 and 15 kpa respectively.The diagnostic value for diagnosing whether having obvious fibrosis and liver cirrhosis was superior to APRI,FIB-4 and FibroIndex multiparameter model.Conclusion FibroTouch has a higher clinical application value in assessing liver fibrosis degree in the patients with chronic liver disease.