Introduction: Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis t...Introduction: Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis to be assessed. Fibroscan measures both elasticity correlated with hepatic fibrosis and CAP correlated with steatosis. The aim of this study was to evaluate hepatic fibrosis and steatosis using pulse elastometry (Fibroscan/CAP). Methods: This was a descriptive and analytical cross-sectional study in which 170 patients were included. It was conducted from October 1 2021 to December 31 2023, i.e. 27 months, in an outpatient clinic in the hepato-gastroenterology department of the Donka national hospital of the CHU Conakry. Results: Of the 170 patients identified, 87 were male (51%) and 83 female (49%), giving a M/F sex ratio of 1.04. The average age of our patients was 40. The 30 - 50 age group was the most affected, with a frequency of 58.23% (n = 99), followed by the 50 age group with a frequency of 29.41% (n = 50). Hepatomegaly, steatotic liver on ultrasonography, transaminase elevation and obesity were the main indications, respectively: (21.76%), (17.65%), (14.71%), and (13.53%). The examinations were requested by hepatogastroenterologists (47.06%), diabetologists (35.88%) and general practitioners (29%). Of the 170 patients, 100 patients (58.82%) had no significant fibrosis F0F1, 39 (22.94%) had moderate fibrosis F2, 20 patients (11.76%) had severe fibrosis F3 and 11 patients (6.47%) had fibrosis F4. Hepatic steatosis: 62 patients (36.47%) had no S0 steatosis;29.41% had S1 steatosis, 20% had S2 steatosis and 24 patients (14.11%) had S3 steatosis. Abdominal ultrasound revealed a normal liver in 67.05% of patients, hepatic steatosis in 29.41% and non-decompensated cirrhosis in 6 cases. Thus, 108 patients had the parameters required to calculate the Fatty Liver Index (FLI), steatosis was present in 20% of our patients, while 29.41% had an undetermined status and 24 14.11% had a normal FLI. Conclusion: Identifying subjects at risk of metabolic steatopathy, diagnosing and managing these patients is a public health issue and one of the future challenges of hepato-gastroenterology. Fibroscan is an increasingly popular screening tool for hepatic fibrosis and steatosis. The fight against obesity must be a priority.展开更多
目的比较FibroScan与FibroTouch对肝纤维化程度的诊断价值。方法收集2013年9月-2014年3月就诊于吉林大学第一医院肝胆胰内科的患者962例,同时行FibroScan和FibroTouch检测。其中33例有肝穿刺病理分期,66例可计算天冬氨酸转氨酶与血小板...目的比较FibroScan与FibroTouch对肝纤维化程度的诊断价值。方法收集2013年9月-2014年3月就诊于吉林大学第一医院肝胆胰内科的患者962例,同时行FibroScan和FibroTouch检测。其中33例有肝穿刺病理分期,66例可计算天冬氨酸转氨酶与血小板比值指数(APRI)(53例慢性乙型肝炎,13例慢性丙型肝炎)。2种检测值之间的相关性采用Spearman秩相关检验。利用受试者工作特征曲线(ROC)分析2种检测方法对肝纤维化程度的诊断价值,并进行比较。结果对所有患者FibroScan与FibroTouch的测量值进行分析,FibroScan与FibroTouch的相关系数为0.866(P<0.05,n=962),与APRI的相关系数分别为0.58、0.63(P<0.05,n=66),与肝穿刺病理分期的相关系数分别为0.67、0.74(P<0.05,n=33)。对于慢性乙型肝炎患者,FibroScan与FibroTouch诊断APRI分期≥2的ROC曲线下面积(AUC)分别为0.761和0.728,两者差异无统计学意义(P=0.61);对于慢性丙型肝炎患者,两者诊断APRI分期≥1的AUC分别为0.810和0.893,两者差异亦无统计学意义(P=0.38)。FibroScan与FibroTouch诊断肝脏病理分期≥S1、≥S2、≥S3、≥S4的AUC分别为0.830 vs 0.889(P=0.15)、0.841 vs 0.835(P=0.90)、0.888 vs0.920(P=0.43)和0.964 vs 0.979(P=0.45)。结论 FibroScan与FibroTouch检测对肝纤维化程度的诊断价值相似,但本研究肝穿刺病例数较少,有待扩大样本进一步研究。展开更多
目的:应用诊断试验Meta分析方法评价瞬时弹性成像技术(fibroscan,FS)诊断慢性病毒性肝炎肝纤维化的准确性以及研究其准确性是否受病因影响.方法:检索万方数据-学术期刊全文库、中国期刊全文数据库(Chinese Journal Full-Text Database,C...目的:应用诊断试验Meta分析方法评价瞬时弹性成像技术(fibroscan,FS)诊断慢性病毒性肝炎肝纤维化的准确性以及研究其准确性是否受病因影响.方法:检索万方数据-学术期刊全文库、中国期刊全文数据库(Chinese Journal Full-Text Database,CJFD)、中国生物医学文献数据库(Chinese Biomedical Literature Database,C B M)、P u b M e d(M e d l i n e)、C o c h r a n e library、EMBASE数据库中有关FS评价慢性病毒性肝炎肝纤维化的中英文文献,进行严格筛选和评价,应用Meta-disc1.4和Stata12.0软件进行统计学分析.结果:共纳入28篇中英文文献.FS诊断慢性病毒性肝炎明显肝纤维化(≥F2)和肝硬化(F=4)的合并敏感度、合并特异度、合并诊断比值比、综合受试者工作特征(summary receiver operating characteristic,SROC)曲线下面积分别为0.72(0.70-0.73)、0.85(0.83-0.87)、18.51(13.28-25.80)、0.88和0.86(0.84-0.88)、0.86(0.85-0.87)、49.14(30.53-79.09)、0.94.Meta分析对所有慢性病毒性肝炎所得的结果,与按慢性丙型肝炎(chronic hepatitis C,CHC)或慢性乙型肝炎(chronic hepatitis B,CHB)病因分类后Meta分析所得的结果相比,未见明显差异.结论:FS诊断肝纤维化分级的准确性良好,尤其对诊断肝硬化.不论是CHC或CHB,FS诊断肝纤维化分级的准确性无明显差别.展开更多
乙肝病毒(hepatitis B virus,HBV)感染导致肝炎、肝纤维化发生,进而发展至肝硬化、肝癌。肝纤维化是可逆的病理过程,而一旦形成肝硬化则不可恢复。肝纤维化程度的测定在评价慢性乙肝患者病情、指导抗病毒治疗、追踪治疗效果等方面显...乙肝病毒(hepatitis B virus,HBV)感染导致肝炎、肝纤维化发生,进而发展至肝硬化、肝癌。肝纤维化是可逆的病理过程,而一旦形成肝硬化则不可恢复。肝纤维化程度的测定在评价慢性乙肝患者病情、指导抗病毒治疗、追踪治疗效果等方面显得极为重要。肝脏弹性测定(Fibroscan)是近年用于肝纤维化无创检测的一种新方法,国外已在丙肝病毒感染者肝纤维化诊断及治疗随访过程中广泛使用。我们研究不同乙肝病毒感染者Fibroscan检测情况,进一步探讨其影响因素及临床运用价值。展开更多
文摘Introduction: Fibroscan is a recent, non-invasive and non-irradiating diagnostic method. It is based on the principle of ultrasound, which enables liver tissue elasticity to be quantified using a probe, and fibrosis to be assessed. Fibroscan measures both elasticity correlated with hepatic fibrosis and CAP correlated with steatosis. The aim of this study was to evaluate hepatic fibrosis and steatosis using pulse elastometry (Fibroscan/CAP). Methods: This was a descriptive and analytical cross-sectional study in which 170 patients were included. It was conducted from October 1 2021 to December 31 2023, i.e. 27 months, in an outpatient clinic in the hepato-gastroenterology department of the Donka national hospital of the CHU Conakry. Results: Of the 170 patients identified, 87 were male (51%) and 83 female (49%), giving a M/F sex ratio of 1.04. The average age of our patients was 40. The 30 - 50 age group was the most affected, with a frequency of 58.23% (n = 99), followed by the 50 age group with a frequency of 29.41% (n = 50). Hepatomegaly, steatotic liver on ultrasonography, transaminase elevation and obesity were the main indications, respectively: (21.76%), (17.65%), (14.71%), and (13.53%). The examinations were requested by hepatogastroenterologists (47.06%), diabetologists (35.88%) and general practitioners (29%). Of the 170 patients, 100 patients (58.82%) had no significant fibrosis F0F1, 39 (22.94%) had moderate fibrosis F2, 20 patients (11.76%) had severe fibrosis F3 and 11 patients (6.47%) had fibrosis F4. Hepatic steatosis: 62 patients (36.47%) had no S0 steatosis;29.41% had S1 steatosis, 20% had S2 steatosis and 24 patients (14.11%) had S3 steatosis. Abdominal ultrasound revealed a normal liver in 67.05% of patients, hepatic steatosis in 29.41% and non-decompensated cirrhosis in 6 cases. Thus, 108 patients had the parameters required to calculate the Fatty Liver Index (FLI), steatosis was present in 20% of our patients, while 29.41% had an undetermined status and 24 14.11% had a normal FLI. Conclusion: Identifying subjects at risk of metabolic steatopathy, diagnosing and managing these patients is a public health issue and one of the future challenges of hepato-gastroenterology. Fibroscan is an increasingly popular screening tool for hepatic fibrosis and steatosis. The fight against obesity must be a priority.
文摘目的比较FibroScan与FibroTouch对肝纤维化程度的诊断价值。方法收集2013年9月-2014年3月就诊于吉林大学第一医院肝胆胰内科的患者962例,同时行FibroScan和FibroTouch检测。其中33例有肝穿刺病理分期,66例可计算天冬氨酸转氨酶与血小板比值指数(APRI)(53例慢性乙型肝炎,13例慢性丙型肝炎)。2种检测值之间的相关性采用Spearman秩相关检验。利用受试者工作特征曲线(ROC)分析2种检测方法对肝纤维化程度的诊断价值,并进行比较。结果对所有患者FibroScan与FibroTouch的测量值进行分析,FibroScan与FibroTouch的相关系数为0.866(P<0.05,n=962),与APRI的相关系数分别为0.58、0.63(P<0.05,n=66),与肝穿刺病理分期的相关系数分别为0.67、0.74(P<0.05,n=33)。对于慢性乙型肝炎患者,FibroScan与FibroTouch诊断APRI分期≥2的ROC曲线下面积(AUC)分别为0.761和0.728,两者差异无统计学意义(P=0.61);对于慢性丙型肝炎患者,两者诊断APRI分期≥1的AUC分别为0.810和0.893,两者差异亦无统计学意义(P=0.38)。FibroScan与FibroTouch诊断肝脏病理分期≥S1、≥S2、≥S3、≥S4的AUC分别为0.830 vs 0.889(P=0.15)、0.841 vs 0.835(P=0.90)、0.888 vs0.920(P=0.43)和0.964 vs 0.979(P=0.45)。结论 FibroScan与FibroTouch检测对肝纤维化程度的诊断价值相似,但本研究肝穿刺病例数较少,有待扩大样本进一步研究。
文摘目的:应用诊断试验Meta分析方法评价瞬时弹性成像技术(fibroscan,FS)诊断慢性病毒性肝炎肝纤维化的准确性以及研究其准确性是否受病因影响.方法:检索万方数据-学术期刊全文库、中国期刊全文数据库(Chinese Journal Full-Text Database,CJFD)、中国生物医学文献数据库(Chinese Biomedical Literature Database,C B M)、P u b M e d(M e d l i n e)、C o c h r a n e library、EMBASE数据库中有关FS评价慢性病毒性肝炎肝纤维化的中英文文献,进行严格筛选和评价,应用Meta-disc1.4和Stata12.0软件进行统计学分析.结果:共纳入28篇中英文文献.FS诊断慢性病毒性肝炎明显肝纤维化(≥F2)和肝硬化(F=4)的合并敏感度、合并特异度、合并诊断比值比、综合受试者工作特征(summary receiver operating characteristic,SROC)曲线下面积分别为0.72(0.70-0.73)、0.85(0.83-0.87)、18.51(13.28-25.80)、0.88和0.86(0.84-0.88)、0.86(0.85-0.87)、49.14(30.53-79.09)、0.94.Meta分析对所有慢性病毒性肝炎所得的结果,与按慢性丙型肝炎(chronic hepatitis C,CHC)或慢性乙型肝炎(chronic hepatitis B,CHB)病因分类后Meta分析所得的结果相比,未见明显差异.结论:FS诊断肝纤维化分级的准确性良好,尤其对诊断肝硬化.不论是CHC或CHB,FS诊断肝纤维化分级的准确性无明显差别.
文摘乙肝病毒(hepatitis B virus,HBV)感染导致肝炎、肝纤维化发生,进而发展至肝硬化、肝癌。肝纤维化是可逆的病理过程,而一旦形成肝硬化则不可恢复。肝纤维化程度的测定在评价慢性乙肝患者病情、指导抗病毒治疗、追踪治疗效果等方面显得极为重要。肝脏弹性测定(Fibroscan)是近年用于肝纤维化无创检测的一种新方法,国外已在丙肝病毒感染者肝纤维化诊断及治疗随访过程中广泛使用。我们研究不同乙肝病毒感染者Fibroscan检测情况,进一步探讨其影响因素及临床运用价值。