CAJ | 학술논문

目的：探讨弹性测量值评估慢性乙型肝炎肝纤维化程度的临床价值及其影响因素。方法根据血清ALT、TBIL水平分为<l×正常值上限(ULN)，l×ULN<<2×ULN和≥2×ULN 3组；根据年龄分<40岁与≥40岁两组，分析F值是否受年龄、ALT、TBIL的影响。其中32例患者在1周内行肝穿刺活检，并对肝纤维化程度进行分期，采用Kruskal-Wallis检验比较不同肝纤维化分期间F值的差异，评价F值判断肝纤维化程度是否有效。用Spearman等级相关关系检验F值与肝纤维化的相关关系。结果根据年龄、ALT、TBIL分组的F值的平均数分别为：8.39±6.41、11.81±8.79 Kpa；8.05±5.47、10.88±8.4、12.94±10.38 Kpa；8.35±5.69、11.39±9.13、20.22±13.26Kpa。32例行肝穿刺者不同肝纤维化分期F值比较，差异有统计学意义（P<0.05），经Spearman等级相关分析显示，F值与肝纤维化分期呈正相关（r=0.78，P<0.05）。结论 F值与肝脏病理纤维化分期呈正相关， Hepatest对乙型肝炎肝纤维化具有较好的诊断价值。
목적：탐토탄성측량치평고만성을형간염간섬유화정도적림상개치급기영향인소。방법근거혈청ALT、TBIL수평분위<l×정상치상한(ULN)，l×ULN<<2×ULN화≥2×ULN 3조；근거년령분<40세여≥40세량조，분석F치시부수년령、ALT、TBIL적영향。기중32례환자재1주내행간천자활검，병대간섬유화정도진행분기，채용Kruskal-Wallis검험비교불동간섬유화분기간F치적차이，평개F치판단간섬유화정도시부유효。용Spearman등급상관관계검험F치여간섬유화적상관관계。결과근거년령、ALT、TBIL분조적F치적평균수분별위：8.39±6.41、11.81±8.79 Kpa；8.05±5.47、10.88±8.4、12.94±10.38 Kpa；8.35±5.69、11.39±9.13、20.22±13.26Kpa。32례행간천자자불동간섬유화분기F치비교，차이유통계학의의（P<0.05），경Spearman등급상관분석현시，F치여간섬유화분기정정상관（r=0.78，P<0.05）。결론 F치여간장병리섬유화분기정정상관， Hepatest대을형간염간섬유화구유교호적진단개치。
Objective To investigate the clinical value of elasticity measurements to assess the degree of liver fibrosis in chronic hepatitis B and its relationship with age,ALT,TBIL's. Methods Patients with chronic hepatitis B from December 2013 to April 2014 the ninth hospital in Nanchang for the study of 364 cases,cirrhosis of the liver ultrasound detector (Hepatest) detection of liver elasticity measurement value(F),all simultaneous detection of liver function in patients,according to serum ALT,TBIL were divided into<1×upper limit of normal (ULN),1×ULN<<2×ULN and≥2×ULN3 group;according to the age of <40 years and ≥40 years of age two group. 32 patients within 1 week of liver biopsy,and staging of liver fibrosis,using kruskal-wallis test to compare the value of different liver fibrosis F differences during the evaluation to determine the degree of liver fibrosis F value is valid. Spearman rank correlation test using the correlation between F value and liver fibrosis. Results ALT grouped according to 8.05±5. 47,10.88±8.4,12.94±10.38 Kpa. According TBIL grouped as:8.35±5.69,11.39±9.13,20.22±13.26Kpa. Grouped according to age was 8.39±6.41,11.81±8.79 Kpa. F value different stages of liver fibrosis patients,the difference was statistically significant (P<0. 05),by the Spearman rank correlation analysis showed,F value and liver fibrosis stage was positively correlated (r=0.78,P<0.05). Conclusion F values associated with liver fibrosis stage was positively correlated with the pathological ,Hepatest has good diag-nostic value for hepatic fibrosis.