进食对Fibroscan实施受控衰减参数准确性的影响

Effect of diets on the accuracy of FibroScan for the assessment of controlled attenuation parameters in patients with non-alcoholic fatty liver disease

目的评价进食对Fibroscan实施受控衰减参数(CAP)准确性的影响。方法使用Fibroscan502机型对103例非酒精性脂肪肝(NAFLD)患者进行CAP(dB/m)测定。所有患者分别于早晨空腹(餐前)和餐后2 h检测,同时行肝脏活体组织检查,以病理结果为“金标准”,分析餐前和餐后CAP的差异。结果共入组103例NAFLD患者,其中单纯NAFLD患者35例,NAFLD合并慢性乙型肝炎(CHB)患者68例。CAP判断轻度、中度及重度脂肪肝绘制ROC曲线,其诊断轻度脂肪肝、中度脂肪肝及重度脂肪肝餐前曲线下面积分别为0.920、0.866、0.963,诊断界值分别为251.5、283.5、318.5 dB/m;餐后曲线下面积分别为0.819、0.866、0.940,诊断界值分别为249.0、288.5、319.6 dB/m;103例NAFLD餐前CAP为(271.47±41.36)dB/m,餐后为(269.75±44.48)dB/m;IQR/M餐前为13(9,17),餐后2 h为12(8,18)。餐前和餐后CAP及IQR/M差异无统计学意义(P>0.05),且各组CAP值和IQR/M在餐前和餐后2 h的比较差异均无统计学意义(P>0.05)。结论空腹和餐后2 h受控衰减参数无明显变化,进食对FibroScan检测脂肪含量无影响。

Objective To investigate the effect of diets on the accuracy of FibroScan for the assessment of controlled attenuation parameters(CAP).Methods Transient elastographies were performed on the 103 non-alcoholic fatty liver(NAFLD)patients with FibroScan502.All patients underwent both Controlled attenuation parameters and liver biopsy.CAP was performed before meal and 2 hours after meal.With liver biopsy as the gold standard,the differences of CAP values before and after meal were compared and analyzed.Results A total of 103 patients were recruited,including 35 patients with NAFLD alone and 68 patients with NAFLD and chronic hepatitis B(CHB).The cut-offs for the CAP values in patients with mild steatosis,moderate steatosis,severe steatosis were 251.5 dB/m,283.5 dB/m,and 318.5dB/m,respectively,with AUROC of 0.920,0.866 and 0.963 before meal;While those after meal were 249dB/m,288.5dB/m,and 319.6 dB/m,respectively,with AUROC of 0.819,0.866,and 0.940.Before meal the average of CAP was 271.47±41.36 dB/m in 103 NAFLD patients whereas that was 269.75±44.48dB/m;And the IQR/M before meal was 13(9,17)comparing to that after meal was 12(8,18).The CAP values and IQR/M before and after meal were not significantly different(P>0.05).Conclusion CAP values are not significantly different before meal and 2 hours after meal in the morning.Diets have no effect on FibroScan for the assessment of controlled attenuation parameters.