瞬时弹性成像技术(FibroScan)检测和血miR-21水平与乙肝肝硬化患者肝脏纤维化程度的关系及对预后的预测

The Relationship Between FibroScan,Blood miR-21 Detection and the Degree of Liver Fibrosis in Patients with Hepatitis B Cirrhosis and the Predictive Value for Prognosis

选取乙肝所致肝硬化(HBC)患者92例为病例组,同期92例慢性乙型肝炎患者为对照组,探讨瞬时弹性成像技术(FibroScan)和血miR-21水平与HBC患者肝脏纤维化程度的关系及对预后的预测价值。结果显示,病例组脾脏/肝脏硬度值、血miR-21水平、肝脏纤维化程度均高于对照组,脾脏/肝脏硬度值、血miR-21水平与HBC患者肝脏纤维化程度呈正相关,二者联合预测时对应敏感度为68.42%,特异度为97.26%,控制患者年龄、体质量、性别等基线资料后,脾脏/肝脏硬度值、血miR-21仍是HBC患者预后死亡的重要危险因素(P<0.05)。本文结果提示FibroScan参数及血miR-21水平变化与肝脏纤维化程度关系密切,是患者预后死亡的独立危险因素,联合检测可从宏观及微观层面为临床评价预后提供参考。

To investigate the relationship between FibroScan,blood miR-21 detection and the degree of liver fibrosis in patients with hepatitis B cirrhosis(HBC)and the value in predicting prognosis,92 patients with HBC were selected as the case group,and 92 patients with chronic hepatitis B were selected as the control group.The results showed that the hardness value of the spleen and the liver,the level of blood miR-21,and the degree of liver fibrosis in the case group were higher than those in the control group.The spleen/liver stiffness values and blood miR-21 levels were positively correlated with the degree of liver fibrosis in HBC patients.The sensitivity of corresponding combined prediction was 68.42%,and specificity was 97.26%.After controlling the patient’s baseline data such as age,body mass and gender,spleen/liver stiffness values and blood miR-21 were still important risk factors for the death of HBC patients(P<0.05).In conclusion,it is suggested that FibroScan parameters and changes of blood miR-21 levels are closely related to the degree of liver fibrosis and are independent risk factors for patients’death.The combined detection can provide a reference for the prognosis of clinical evaluation from the macro and micro levels.