FibroScan对预测乙肝肝硬化预后的价值临床研究

Clinical study on the value of FibroScan in predicting the prognosis of hepatitis B cirrhosis

目的评价FibroScan对预测乙肝肝硬化预后的临床价值研究。方法选择2018年1月—2019年6月我院收治的80例无肝硬化患者(A组)及80例肝硬化患者(B组),采用FibroScan、肝组织学、肝功能、血常规检测和肝脏B超、电子胃镜检查,观察对比两组患者的肝功能、血常规主要指标及FS值,比较不同肝纤维化分期和食管胃静脉曲张程度患者的FS值,分析影响肝硬化患者FS值的因素,分析FS值、血小板计数、凝血酶原时间和门静脉宽度预测发生食管胃静脉曲张程度的诊断效能。结果A组的AST、ALT、WBC、HGB、PLT均高于B组(P<0.05),PT、FS值和门静脉宽度低于B组(P<0.05);A组肝纤维化Ⅰ、Ⅱ级患者的FS值均与0级患者相比有差异(P<0.05),Ⅱ级患者的FS值较Ⅰ级患者存在差异(P<0.05);B组食管胃静脉曲张中、重度患者的FS值均较轻度患者存在差异(P<0.05),重度患者的FS值较中度患者存在差异(P<0.05);PT与FS值呈正相关(P<0.05);PLT、PT+门静脉宽度+FS值对肝硬化发生食管胃静脉曲张程度的诊断效能最高。结论乙肝肝硬化患者的FS值与乙肝非肝硬化患者比较具有明显区别,PLT、PT+门静脉宽度+FS值三者联合检测对预测食管胃静脉曲张程度具有较好的诊断价值,故FibroScan应成为预测乙肝肝硬化预后的新指标。

Objective To evaluate of FibroScan in predicting prognosis of hepatitis B cirrhosis.Methods Eighty patients without cirrhosis(group A)and Eighty patients with cirrhosis(group B)admitted to our hospital from January 2018 to June 2019 were selected.FibroScan,liver histology,liver function,blood routine examination and liver B-ultrasonography and electronic gastroscopy were used to observe and compare the liver function,main blood routine indexes and FS values of the two groups,and to compare the patients with different stages of liver fibrosis and the degree of esophagogastric varices.FS value,the factors affecting FS value in patients with liver cirrhosis were analyzed.The diagnostic efficacy of FS value,platelet count,prothrombin time and portal vein width in predicting the degree of esophagogastric varices was analyzed.Results AST,ALT,WBC,HGB and PLT in group A were higher than those in group B(P<0.05),while PT,FS and portal vein width were lower than those in group B(P<0.05).FS values of patients with grade I and II hepatic fibrosis in group A were different from those of grade 0(P<0.05),FS values of patients with grade II were different from those of patients with grade I(P<0.05).FS values of patients with moderate and severe esophagogastric varices in group B were different from those of patients with mild hepatic fibrosis(P<0.05).FS values of patients with severe hepatic fibrosis were different from those of patients with moderate hepatic fibrosis(P<0.05).PT was positively correlated with FS(P<0.05).PLT,PT+portal vein width+FS value had the highest diagnostic efficacy for the degree of esophagogastric varices in cirrhosis(P<0.05).Conclusion The FS value of patients with hepatitis B cirrhosis is different from that of patients with non-hepatitis B cirrhosis.The combined detection of PLT,PT+portal vein width+FS value has better diagnostic value in predicting the degree of esophagogastric varices.Therefore,FibroScan should be a new prognostic index for hepatitis B cirrhosis.