实时与瞬时弹性成像对非酒精性脂肪肝患者肝纤维化程度诊断评估及预后评估价值分析

Diagnostic Value and Prognostic Evaluation Ability of Real-Time Elastography and FibroScan in Evaluation of Liver Fibrosis About Non-Alcoholic Fatty Liver Disease Patients

目的观察瞬时弹性成像技术(FS)和实时组织超声弹性成像技术(RTE)在非酒精性脂肪肝患者肝纤维化程度无创诊断评估的效果及预后的评估价值。方法选取241例NAFLD患者为研究对象。其中合并肝纤维化的136例为观察组,未合并肝纤维化患者105例为对照组。两组均给予FS及RTE检查,比较两组患者一般资料及检查结果差异。观察比较两组患者FS及RTE检查结果,判断两种检测方法及其联合使用的诊断效能。观察组给予6个月抗肝纤维化药物治疗,观察治疗效果及治疗前后实验室指标及FS及RTE检查结果变化情况,判断其对预后评估的效能。结果实验室指标观察组在ALT、AST、TC、TG均高于对照组,差异均有统计学意义(P<0.05),治疗前观察组LFI值平均为(3.82±1.42),高于对照组2.78±0.83,差异有统计学意义(P<0.05),观察组LSM值平均为(19.52±2.98),高于对照组(5.51±1.11),差异有统计学意义(P<0.05)。LFI值、LSM值及其联合诊断的ROC曲线参数面积均高于0.700,表明两指标均具有较高的诊断效能,但两者联合的灵敏度及特异度高于单一指标诊断结果(P<0.05)。观察组患者给予连续6个月抗肝纤维化药物治疗后,实验室指标及LFI、LSM值均有显著下降(P<0.05)。结论FS和RTE对NAFLD患者肝纤维化进程的诊断效果均有较高的价值,能够准确的判断肝纤维化的程度,操作简单,准确度高,可重复性强,可作为患者抗纤维化治疗预后评估的无创检测手段,建议二者联合应用,进一步提高诊断准确性。

Objective Observe the effect of diagnosis and evaluation of the effect after treatment of real-time elastography and FibroScan in evaluation of liver fibrosis about Non-alcoholic fatty liver disease patients.Methods Selected 241 NAFLD patients admitted as the research objects.Among them,136 patients with liver fibrosis were in the observation group,and 105 patients without liver fibrosis were in the control group.Both groups were given FS and RTE examinations,and the differences in general information and examination results of the two groups were compared.Observe and compare the results of FS and RTE examinations of the two groups of patients,and judge the diagnostic efficacy of the two detection methods and their combined use.Patients in the observation group were treated with anti-hepatic fibrosis drugs for 6 months to observe the treatment effect and the changes in laboratory indicators,FS and RTE examination results before and after treatment,and judge its effectiveness in prognostic evaluation.Results The ALT,AST,TC,and TG of the observation group of laboratory indicators were all higher than those of the control group(P<0.05),and the differences were statistically significant.The LFI value of the observation group before treatment was 3.82±1.42 on average,which was higher than the control group 2.78±0.83 The difference was statistically significant(t=39.652,P<0.05).The average LSM value of the observation group was 19.52±2.98,which was higher than that of the control group by 5.51±1.11.The difference was statistically significant(t=59.672,P<0.05).The LFI value,LSM value and the ROC curve parameter area of the combined diagnosis are all higher than 0.700,indicating that the two indicators have higher diagnostic efficiency,but the sensitivity and specificity of the combination of the two are higher than the diagnosis result of a single indicator(P<0.05).After the observation group was treated with anti-liver fibrosis drugs for 6 consecutive months,the laboratory indexes,LFI and LSM values all decreased significantly(P<0.05).Conclusion Both FS and RTE are of high value in the diagnosis of liver fibrosis in patients with NAFLD.They can accurately determine the degree of liver fibrosis,simple operation,high accuracy,and strong repeatability.They can be used as anti-fibrosis treatments for patients As a non-invasive detection method for prognostic evaluation,it is recommended that the two be combined to further improve the accuracy of diagnosis.