中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2013年
5期
269-272
,共4页
陈巍%翁彭剑%高国生%颜华东%毛达峰%祝成亮
陳巍%翁彭劍%高國生%顏華東%毛達峰%祝成亮
진외%옹팽검%고국생%안화동%모체봉%축성량
肝硬化%声脉冲辐射力成像%肝脏剪切波速%天冬氨酸转氨酶-血小板比值指数%Forns%S指数%FIB-4
肝硬化%聲脈遲輻射力成像%肝髒剪切波速%天鼕氨痠轉氨酶-血小闆比值指數%Forns%S指數%FIB-4
간경화%성맥충복사력성상%간장전절파속%천동안산전안매-혈소판비치지수%Forns%S지수%FIB-4
Liver cirrhosis%Acoustic radiation force impulse%Liver shear wave velocity%AST to platelet ratio index%Forns%S index%FIB-4
目的 研究声脉冲辐射力成像(ARFI)技术测量的肝脏剪切波速及四种常用纤维化评分[天冬氨酸转氨酶-血小板比值指数(APRI)、Forns、S指数、FIB-4]无创评估慢性肝炎患者明显肝纤维化的临床价值.方法 运用ARFI技术对2010年10月至2013年4月宁波市第二医院237例经肝活检证实的慢性肝炎患者测量肝脏剪切波速,同时检测血清学指标,计算APRI、Forns、S指数和FIB-4四种评分.所有患者肝脏纤维化程度按Scheuer系统标准分为S0～S4,≥S2者为明显肝纤维化.采用受试者工作特征(ROC)曲线评价剪切波速、四种常用纤维化评分单项及联合应用对明显肝纤维化的诊断价值.结果 肝脏剪切波速值与肝纤维化分级(S)有较好的相关性(r =0.46,P＜0.01).剪切波速和四种常用纤维化评分(APRI、Forns、S指数、FIB-4)诊断明显肝纤维化的ROC曲线下面积(AUC)分别为0.758(0.696 ～0.821)、0.727(0.662～0.793)、0.777(0.717～0.836)、0.747(0.684 ～0.810)、0.737(0.673 ～0.802).对剪切波速和四种常用纤维化评分进行多因素Logistic回归分析构建联合预测模型,其AUC达到0.810.结论 基于ARFI技术的肝脏剪切波速对慢性肝炎患者明显肝纤维化的预测有一定价值,与其他无创诊断指标联合应用可以提高预测的准确性.
目的 研究聲脈遲輻射力成像(ARFI)技術測量的肝髒剪切波速及四種常用纖維化評分[天鼕氨痠轉氨酶-血小闆比值指數(APRI)、Forns、S指數、FIB-4]無創評估慢性肝炎患者明顯肝纖維化的臨床價值.方法 運用ARFI技術對2010年10月至2013年4月寧波市第二醫院237例經肝活檢證實的慢性肝炎患者測量肝髒剪切波速,同時檢測血清學指標,計算APRI、Forns、S指數和FIB-4四種評分.所有患者肝髒纖維化程度按Scheuer繫統標準分為S0～S4,≥S2者為明顯肝纖維化.採用受試者工作特徵(ROC)麯線評價剪切波速、四種常用纖維化評分單項及聯閤應用對明顯肝纖維化的診斷價值.結果 肝髒剪切波速值與肝纖維化分級(S)有較好的相關性(r =0.46,P＜0.01).剪切波速和四種常用纖維化評分(APRI、Forns、S指數、FIB-4)診斷明顯肝纖維化的ROC麯線下麵積(AUC)分彆為0.758(0.696 ～0.821)、0.727(0.662～0.793)、0.777(0.717～0.836)、0.747(0.684 ～0.810)、0.737(0.673 ～0.802).對剪切波速和四種常用纖維化評分進行多因素Logistic迴歸分析構建聯閤預測模型,其AUC達到0.810.結論 基于ARFI技術的肝髒剪切波速對慢性肝炎患者明顯肝纖維化的預測有一定價值,與其他無創診斷指標聯閤應用可以提高預測的準確性.
목적 연구성맥충복사력성상(ARFI)기술측량적간장전절파속급사충상용섬유화평분[천동안산전안매-혈소판비치지수(APRI)、Forns、S지수、FIB-4]무창평고만성간염환자명현간섬유화적림상개치.방법 운용ARFI기술대2010년10월지2013년4월저파시제이의원237례경간활검증실적만성간염환자측량간장전절파속,동시검측혈청학지표,계산APRI、Forns、S지수화FIB-4사충평분.소유환자간장섬유화정도안Scheuer계통표준분위S0～S4,≥S2자위명현간섬유화.채용수시자공작특정(ROC)곡선평개전절파속、사충상용섬유화평분단항급연합응용대명현간섬유화적진단개치.결과 간장전절파속치여간섬유화분급(S)유교호적상관성(r =0.46,P＜0.01).전절파속화사충상용섬유화평분(APRI、Forns、S지수、FIB-4)진단명현간섬유화적ROC곡선하면적(AUC)분별위0.758(0.696 ～0.821)、0.727(0.662～0.793)、0.777(0.717～0.836)、0.747(0.684 ～0.810)、0.737(0.673 ～0.802).대전절파속화사충상용섬유화평분진행다인소Logistic회귀분석구건연합예측모형,기AUC체도0.810.결론 기우ARFI기술적간장전절파속대만성간염환자명현간섬유화적예측유일정개치,여기타무창진단지표연합응용가이제고예측적준학성.
Objective To evaluate the clinical application of liver shear wave velocity (SWV) in comparison with common serum score systems [AST to platelet ratio index (APRI),Forns,S index and FIB-4] in assessment of liver fibrosis in patients with chronic hepatitis.Methods A total of 237 chronic hepatitis patients with liver fibrosis confirmed by liver biopsy,who were admitted in Ningbo Second Hospital during October 2010 and April 2013,were enrolled in the study.Liver shear wave velocity were measured by acoustic radiation force impulse (ARFI),and the score of APRI,Forns,S index and FIB-4 were calculated based on the measurement of serum markers.Liver fibrosis stages were classified as S0-S4 according to the Scheuer scoring system,and stages ≥ S2 were identified as significant liver fibrosis.The diagnosis value of SWV,4 common score systems and their combination for significant liver fibrosis was evaluated by receiver operating characteristic curve (ROC).Results A significant linear correlation was found between SWV and the stage of fibrosis (r =0.46,P ＜ 0.01).The areas under the ROCs of SWV and 4 common score systems (APRI,Forns,S index and FIB-4) for the diagnosis of significant liver fibrosis were 0.758 (0.696-0.821),0.727 (0.662-0.793),0.777 (0.717-0.836),0.747 (0.684-0.810) and 0.737 (0.673-0.802),respectively.The area under the ROC of the combined prediction nodel established with Logistic regression was 0.810.Conclusion Liver shear wave velocity measured by ARFI is of clinical value in noninvasive assessment of liver fibrosis,and the prediction accuracy can be improved when it is combined with other noninvasive indices.
