中国肝脏病杂志（电子版）
中國肝髒病雜誌（電子版）
중국간장병잡지（전자판）
CHINESE JOURNAL OF LIVER DISEASES(ELECTRONIC VERSION)
2014年
1期
18-21
,共4页
刘京%刘映霞%董常峰%姚思敏%李莎茜%袁静%陈川铁%赵美芬%林益敏%彭忠田
劉京%劉映霞%董常峰%姚思敏%李莎茜%袁靜%陳川鐵%趙美芬%林益敏%彭忠田
류경%류영하%동상봉%요사민%리사천%원정%진천철%조미분%림익민%팽충전
无创诊断%慢性乙型病毒性肝炎%肝纤维化
無創診斷%慢性乙型病毒性肝炎%肝纖維化
무창진단%만성을형병독성간염%간섬유화
Noninvasive diagnosis%Chronic Hepatic B%Liver ifbrosis
目的：声辐射力脉冲成像技术（ARFI）及血清学诊断模型（Forns指数、FIB-4、APRI）对慢性乙型病毒性肝炎肝纤维化评估的价值。方法111例确诊为慢性乙型病毒性肝炎患者，根据肝组织活检病理分期结果分组：无明显肝纤维化组（S0、S1）40例，明显肝纤维化组（≥S2）48例、早期肝硬化组（S4）23例。每例患者同期进行ARFI、Forns指数、FIB-4、APRI的评估。比较无创诊断模型与肝脏病理的相关性，并根据受试者工作特征曲线（ROC）分析无创诊断模型对肝纤维化的诊断价值。结果ARFI、Forns指数、FIB-4、APRI 4种无创诊断方法与肝组织活检具有良好的一致性，其皮尔逊相关系数（Pearson correlation coefifcient）分别为0.882、0.639、0.589、0.418。明显肝纤维化组（≥S2）及早期肝硬化组，ARFI的诊断价值均优于FIB-4（Z=2.882，P=0.004；Z=3.215，P=0.001）、APRI （Z=4.850，P＜0.001；Z=3.198，P=0.001）、Forns指数（Z=2.182，P=0.029；Z=2.798，P=0.005）。结论ARFI对明显肝纤维化及早期肝硬化的诊断具有较高的价值，值得推广。
目的：聲輻射力脈遲成像技術（ARFI）及血清學診斷模型（Forns指數、FIB-4、APRI）對慢性乙型病毒性肝炎肝纖維化評估的價值。方法111例確診為慢性乙型病毒性肝炎患者，根據肝組織活檢病理分期結果分組：無明顯肝纖維化組（S0、S1）40例，明顯肝纖維化組（≥S2）48例、早期肝硬化組（S4）23例。每例患者同期進行ARFI、Forns指數、FIB-4、APRI的評估。比較無創診斷模型與肝髒病理的相關性，併根據受試者工作特徵麯線（ROC）分析無創診斷模型對肝纖維化的診斷價值。結果ARFI、Forns指數、FIB-4、APRI 4種無創診斷方法與肝組織活檢具有良好的一緻性，其皮爾遜相關繫數（Pearson correlation coefifcient）分彆為0.882、0.639、0.589、0.418。明顯肝纖維化組（≥S2）及早期肝硬化組，ARFI的診斷價值均優于FIB-4（Z=2.882，P=0.004；Z=3.215，P=0.001）、APRI （Z=4.850，P＜0.001；Z=3.198，P=0.001）、Forns指數（Z=2.182，P=0.029；Z=2.798，P=0.005）。結論ARFI對明顯肝纖維化及早期肝硬化的診斷具有較高的價值，值得推廣。
목적：성복사력맥충성상기술（ARFI）급혈청학진단모형（Forns지수、FIB-4、APRI）대만성을형병독성간염간섬유화평고적개치。방법111례학진위만성을형병독성간염환자，근거간조직활검병리분기결과분조：무명현간섬유화조（S0、S1）40례，명현간섬유화조（≥S2）48례、조기간경화조（S4）23례。매례환자동기진행ARFI、Forns지수、FIB-4、APRI적평고。비교무창진단모형여간장병리적상관성，병근거수시자공작특정곡선（ROC）분석무창진단모형대간섬유화적진단개치。결과ARFI、Forns지수、FIB-4、APRI 4충무창진단방법여간조직활검구유량호적일치성，기피이손상관계수（Pearson correlation coefifcient）분별위0.882、0.639、0.589、0.418。명현간섬유화조（≥S2）급조기간경화조，ARFI적진단개치균우우FIB-4（Z=2.882，P=0.004；Z=3.215，P=0.001）、APRI （Z=4.850，P＜0.001；Z=3.198，P=0.001）、Forns지수（Z=2.182，P=0.029；Z=2.798，P=0.005）。결론ARFI대명현간섬유화급조기간경화적진단구유교고적개치，치득추엄。
Objective To assessment the value of acoustic radiation force impulse (ARFI) and serological diagnosis model (Forns index, FIB-4, APRI) to liver fibrosis of chronic hepatic B. Methods Total of 111 patient confirmed as CHB, divided into groups according to the result of the liver biopsy: no significant liver ifbrosis group (S0, S1) 40 cases, signiifcantly ifbrosis group (≥S2) 48 cases, early cirrhosis group (S4) 23 cases. During the same period, each patient with the assessment of ARFI, Forns index, Fib-4 and APRI. Compared the correlation of noninvasive diagnosis model and liver biopsy. Moreover, analysis the diagnostic value of noninvasive liver ifbrosis model to the liver ifbrosis according to the receiver-operating characteristic curve. Results ARFI, Forns index, FIB-4, APRI, the four kinds of noninvasive diagnostic method has a good consistency with liver biopsy, and their Pearson correlation coefifcient were 0.882, 0.639, 0.589, 0.418. The assessment value of ARFI to signiifcantly ifbrosis group (≥S2) was superior to FIB-4 (Z=2.882, P=0.004;Z=3.215, P=0.001), APRI (Z=4.850, P<0.001;Z=3.198, P=0.001), Forns index (Z=2.182, P=0.029;Z=2.798, P=0.005). Conclusions The assessment value to signiifcantly ifbrosis and early cirrhosis of ARFI is higher than others and worthy of promotion.
