FibroScan定量肝硬度值为75 kPa的诊断特异性分析

Diagnostic specificity of FibroScan quantitative liver stiffness value of 75 kPa

目的分析FibroScan检测肝硬度值为75 kPa的诊断特异性。方法收集2013年6月至2020年7月中山市第二人民医院肝病门诊及住院肝病患者80例,男性71例,女性9例,年龄(47.4±9.3)岁。根据FibroScan定量肝硬度值进行分组,肝硬度值为75 kPa者纳入试验组(30例),肝硬度值在7~75 kPa之间者纳入对照组(50例)。所有患者进行肝脏超声检查、肝功能检查及临床诊断,对结果进行分析对比。结果试验组肝硬化失代偿期、酒精性肝病以及肝癌患者比例分别为60.0%(18/30)、70.0%(21/30)、20.0%(6/30),均高于对照组[分别为36.0%(18/50)、30.0%(15/50)、2.0%(1/50)],而中/重度慢性肝炎者在试验组中比例明显低于对照组[3.3%(1/30)比36.0%(18/50)],两组比较,差异均有统计学意义(均P<0.05);肝硬化代偿期患者在两组中所占比例差异无统计学意义(P>0.05)。在研究的6项肝功能指标中,试验组总胆红素、直接胆红素、碱性磷酸酶出现异常改变的患者比例分别为70.0%(20/30)、90.0%(27/30)、66.7%(20/30),均较对照组高[分别为38.0%(19/50)、58.0%(29/50)、30.0%(15/50)],组间比较差异均有统计学意义(均P<0.05);两组患者谷草转氨酶、谷丙转氨酶、间接胆红素出现异常改变的比例比较,差异均无统计学意义(均P>0.05)。结论FibroScan检测肝硬度值为75 kPa时的临床诊断具有一定的特异性,结合超声检查和肝功能检查可以为临床诊断提供很好的参考依据。

Objective To analyze the diagnostic specificity of the liver stiffness value of 75 kPa by FibroScan.Methods A total of 80 outpatients and inpatients with liver diseases treated at Zhongshan Second People's Hospital from June 2013 to July 2020 were selected,including 71 males and 9 females,who were(47.4±9.3)years old.According to their FibroScan quantitative liver stiffness values,the 30 cases whose FibroScan liver stiffness values were 75 kPa were set as an experimental group,and the other 50 patients whose FibroScan liver stiffness values were 7 to 75 kPa were set as a control group.All the patients had liver ultrasound examination,liver function examination,and clinical diagnosis.The results were analyzed and compared.Results The proportions of the patientswith decompensated cirrhosis,alcoholic liver disease,and liver cancer in the experimental group was higher than those in the control group[60.0%(18/30)vs.36.0%(18/50),70.0%(21/30)vs.30.0%(15/50),and 20.0%(6/30)vs.2.0%(1/50);all P<0.05].Fewer patients had moderate/severe chronic hepatitis in the experimental group than in the control group[3.3%(1/30)vs.36.0%(18/50);P<0.05].There was no statistical difference in the proportion of the patients with compensated cirrhosis between the two groups(P>0.05).More patients had abnormal total bilirubin,direct bilirubin,and alkaline phosphatase in the trial group than in the control group[70.0%(20/30)vs.38.0%(19/50),90.0%(27/30)vs.58.0%(29/50),and 66.7%(20/30)and 30.0%(15/50);all P<0.05].There were no statistical differences in the proportions of the patients with abnormal glutamic oxaloacetic transaminase,glutamic-pyruvic transaminase,and indirect bilirubin between the two groups(all P>0.05).Conclusions The clinical diagnosis of liver stiffness value of 75 kPa detected by FibroScan has a certain specificity.The combination of ultrasound and liver function examination can provide good references for clinical diagnosis.