中华实验和临床病毒学杂志
中華實驗和臨床病毒學雜誌
중화실험화림상병독학잡지
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL VIROLOGY
2014年
2期
96-98
,共3页
邹志强%王均蒙%王莉%刘友德%郭砚梅
鄒誌彊%王均矇%王莉%劉友德%郭硯梅
추지강%왕균몽%왕리%류우덕%곽연매
肝炎,乙型,慢性%肝硬化%脂肪肝
肝炎,乙型,慢性%肝硬化%脂肪肝
간염,을형,만성%간경화%지방간
Hepatitis B,chronic%Liver cirrhosis%Fatty liver
目的 探讨慢性乙型肝炎合并脂肪变对Fibroscan检测肝脏硬度值(liver stiffness,LS)的影响.方法 收集自2010年1月到2013年5月行肝脏病理学检查,同时行Fibroscan检测肝脏LS的慢性乙型肝炎患者303例,同时收集肝功能及生化学指标等.比较不同程度肝纤维化合并脂肪变及不合并脂肪变的患者LS值及肝脏纤维化程度相同合并不同程度脂肪变的LS值,用受试者工作曲线(Receiver Operating Characteristic,ROC曲线)分析,得出合并脂肪变及不合并脂肪变的各期肝纤维化的cut-off值.结果 排除BMI＞ 28 kg/m2和ALT＞200U/ml后符合入选标准的237例,其中合并脂肪变者75例(31.6％),不合并脂肪变者162例(68.4％),各期纤维化F1、F2、F3和F4及合并脂肪肝的LS值(kPa)分别是5.3 ±-1.4 vs5.9 ±1.9,9.5±4.2 vs8.7±3.0,18.4±7.5 vs 15.0±6.6,21.4±7.5 vs27.6±5.9 kPa,两组差异无统计学意义(P＞0.05),但纤维化程度轻者,脂肪变有增加LS值的趋势,肝纤维化程度重者,脂肪变有降低LS值的趋势.仅在肝脏轻-中度纤维化(F2)程度下,合并中度的脂肪变(S2)的LS值较不合并脂肪变(S0)(P＜0.05)及合并轻度的脂肪变(S1)的LS值高(P＜0.05).三者LS值分别为(11.3±5.5)、(8.7±3.0)、(8.1±-2.4)kPa.结论 慢性乙型肝炎合并脂肪变对肝脏硬度值影响较小,仅在F2S2时LS较不合并脂肪肝(S0)及轻度脂肪肝(S1)者高.
目的 探討慢性乙型肝炎閤併脂肪變對Fibroscan檢測肝髒硬度值(liver stiffness,LS)的影響.方法 收集自2010年1月到2013年5月行肝髒病理學檢查,同時行Fibroscan檢測肝髒LS的慢性乙型肝炎患者303例,同時收集肝功能及生化學指標等.比較不同程度肝纖維化閤併脂肪變及不閤併脂肪變的患者LS值及肝髒纖維化程度相同閤併不同程度脂肪變的LS值,用受試者工作麯線(Receiver Operating Characteristic,ROC麯線)分析,得齣閤併脂肪變及不閤併脂肪變的各期肝纖維化的cut-off值.結果 排除BMI＞ 28 kg/m2和ALT＞200U/ml後符閤入選標準的237例,其中閤併脂肪變者75例(31.6％),不閤併脂肪變者162例(68.4％),各期纖維化F1、F2、F3和F4及閤併脂肪肝的LS值(kPa)分彆是5.3 ±-1.4 vs5.9 ±1.9,9.5±4.2 vs8.7±3.0,18.4±7.5 vs 15.0±6.6,21.4±7.5 vs27.6±5.9 kPa,兩組差異無統計學意義(P＞0.05),但纖維化程度輕者,脂肪變有增加LS值的趨勢,肝纖維化程度重者,脂肪變有降低LS值的趨勢.僅在肝髒輕-中度纖維化(F2)程度下,閤併中度的脂肪變(S2)的LS值較不閤併脂肪變(S0)(P＜0.05)及閤併輕度的脂肪變(S1)的LS值高(P＜0.05).三者LS值分彆為(11.3±5.5)、(8.7±3.0)、(8.1±-2.4)kPa.結論 慢性乙型肝炎閤併脂肪變對肝髒硬度值影響較小,僅在F2S2時LS較不閤併脂肪肝(S0)及輕度脂肪肝(S1)者高.
목적 탐토만성을형간염합병지방변대Fibroscan검측간장경도치(liver stiffness,LS)적영향.방법 수집자2010년1월도2013년5월행간장병이학검사,동시행Fibroscan검측간장LS적만성을형간염환자303례,동시수집간공능급생화학지표등.비교불동정도간섬유화합병지방변급불합병지방변적환자LS치급간장섬유화정도상동합병불동정도지방변적LS치,용수시자공작곡선(Receiver Operating Characteristic,ROC곡선)분석,득출합병지방변급불합병지방변적각기간섬유화적cut-off치.결과 배제BMI＞ 28 kg/m2화ALT＞200U/ml후부합입선표준적237례,기중합병지방변자75례(31.6％),불합병지방변자162례(68.4％),각기섬유화F1、F2、F3화F4급합병지방간적LS치(kPa)분별시5.3 ±-1.4 vs5.9 ±1.9,9.5±4.2 vs8.7±3.0,18.4±7.5 vs 15.0±6.6,21.4±7.5 vs27.6±5.9 kPa,량조차이무통계학의의(P＞0.05),단섬유화정도경자,지방변유증가LS치적추세,간섬유화정도중자,지방변유강저LS치적추세.부재간장경-중도섬유화(F2)정도하,합병중도적지방변(S2)적LS치교불합병지방변(S0)(P＜0.05)급합병경도적지방변(S1)적LS치고(P＜0.05).삼자LS치분별위(11.3±5.5)、(8.7±3.0)、(8.1±-2.4)kPa.결론 만성을형간염합병지방변대간장경도치영향교소,부재F2S2시LS교불합병지방간(S0)급경도지방간(S1)자고.
Objective To investigate the impact of steatosis on liver stiffness (LS) detected by transient elastography (Fibroscan) in patients with chronic hepatitis B (CHB).Methods 303 cases of CHB who underwent liver pathology and Fibroscan from January 2010 to May 2013 were retrospectively analysed.Biochemical parameters were collected.LS values in patients of CHB with and without steatosis were compared.LS values in patients of the same stage of liver fibrosis combined with different degrees of steatosis were compared using ANOVA.Cut-off values were obtained by Receiver Operating Characteristic (ROC curve) analysis.Results 273 cases were included when excluding BMI ＞ 28 kg/m2 and ALT ＞200U/ml.Steatosis was present in 75 (31.6％) cases,steatosis was absent in 162 (68.4％) cases.In every stage of fibrosis,combining with steatosis has no significant impact on LS values.LS(kPa) were 5.3 ±1.4vs5.9±1.9,9.5±4.2 vs8.7 ±3.0,18.4 ±7.5 vs 15.0 ±6.6,21.4 ±7.5 vs27.6±5.9 kPa,respectively.(P ＞ 0.05).While in the degree of F2,LS values in patients combined with the steatosis (S2) were higher than those in patients without steatosis (S0) (P ＜ 0.05) and with mild steatosis (S1) (P ＜0.05).LS values(kPa) were 11.28 ±5.54,8.68 ±2.95,8.12 ±2.44,respectively.Conclusions LS values have no significant difference in patients of CHB with steatosis and without steatosis with different degree of liver fibrosis.In patients with fibrosis stage of F2,LS values in those combined with moderate steatosis (S2) were higher than those without steatosis and with mild steatosis.
