瞬时弹性扫描弹性值和血清学标记物与乙肝患者肝纤维化的相关性

Study on Correlation of Fibroscan Analysis and Serological Indexes with Liver Fibrosis in Patients with Hepatitis B

目的:探讨瞬时弹性扫描(FS)弹性值和血清学标记物与乙肝病人肝纤维化程度的相关性。方法:178例慢性乙肝患者采用化学发光法检测透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)水平,同时采用FS技术测量肝硬度值(LSM)评估肝纤维化程度,分析FS弹性值、血清学标记物与乙肝患者肝纤维化程度的相关性。结果:根据弹性值把FS检测结果分为4级,178例患者中F1级108例,F2级38例,F3级16例,F4级16例; SM评分F2以上患者,血清肝纤维化4项指标(LN的r=0. 282,P=0. 018; PCⅢ的r=0. 378,P=0. 001; CⅣ的r=0. 534,P=0. 000; HA的r=0. 305,P=0. 010)与FS弹性值有相关性,差异有统计学意义(P <0. 05)。结论:FS技术可预测慢性乙肝病人肝纤维化程度,但是血清学标记物更适合早期发病检测,两者有相关性。

Objective：To study the correlation between non-invasive fibroScan analysis and various serological indexes in predicting the progression of liver fibrosis in hepatitis B patients for better understanding of the use of these measurements in clinical treatment. Methods： A total of 178 patients enrolled in this study with liver fibrosis and cirrhosis caused by chronic viral hepatitis B. received both fibroScan test and 4 different serological tests including LN, PCIII, CIV and HA. Results： FibroScan detection was set with LSM as 9.2 kPa. There were 4 different grades of liver fibrosis severity. Based on the grade of liver fibrosis detected by fibroScan, the serological indexes were analyzed regarding to their correlation with the stage of the progression of liver fibrosis. The results were LN r = 0.282,p = 0.018;PCⅢ r = 0.378,p = 0.001;CⅣ r = 0.534;HA r = 0.305,p = 0.010. In addition, it was found that all of the serological indexes were significantly elevated in the early stage （F0） of liver fibrosis. Conclusion： Although there was no close correlation between the grades of liver fibrosis detected by fibroScan and reflected by serological indexes, the data presented here demonstrate that fibroScan analysis and serological indexes are complementary in the diagnosis of liver fibrosis： serological indexes indicating the initiation of liver fibrosis and fibroScan can measure the degree of liver fibrosis during the stabilized development phase of this pathogenesis.