安徽医科大学学报
安徽醫科大學學報
안휘의과대학학보
ACTA UNIVERSITY MEDICINALIS ANHUI
2015年
6期
843-846,847
,共5页
叶子%程君%陈国胜%周仲松%赵冬梅%谢琴秀%江晓平%叶英%李家斌
葉子%程君%陳國勝%週仲鬆%趙鼕梅%謝琴秀%江曉平%葉英%李傢斌
협자%정군%진국성%주중송%조동매%사금수%강효평%협영%리가빈
瞬时弹性成像%肝脏纤维化%慢性乙型肝炎
瞬時彈性成像%肝髒纖維化%慢性乙型肝炎
순시탄성성상%간장섬유화%만성을형간염
FibroScan%liver fibrosis%chronic hepatitis B
目的：评估瞬时弹性超声成像（FibroScan）在慢性乙型肝炎（CHB）患者肝脏纤维化诊断中的临床应用价值。方法选取进行肝脏穿刺活检的 CHB 患者185例，收集血常规、肝功能等血清学指标。同时患者应用 FibroScan 进行肝脏弹性测量值（LSM）测量，分析 LSM 与肝纤维化的相关性及其影响因素。结果以肝脏穿刺病理结果为金标准， Spearman 等级相关性分析提示 LSM 与肝纤维化呈显著相关性（P <0.05）。单因素方差分析提示天门冬氨酸氨基转移酶、碱性磷酸酶、血小板、凝血酶原时间百分活动度与 LSM值呈相关性。受试者工作特性曲线（ROC）分析，S2~ S4期诊断界值依次为6.0、9.75、14.2 kPa，各阶段曲线下面积均>0.95。双变量分析提示 LSM 值与升高的转氨酶呈显著相关性（P <0.05）。ROC 分析转氨酶升高组 S1~ S2期界值为6.25 kPa，S3~ S4期界值为15.3 kPa。结论 FibroScan 诊断CHB 患者肝脏纤维化有较高的临床应用价值，但是受转氨酶影响大。
目的：評估瞬時彈性超聲成像（FibroScan）在慢性乙型肝炎（CHB）患者肝髒纖維化診斷中的臨床應用價值。方法選取進行肝髒穿刺活檢的 CHB 患者185例，收集血常規、肝功能等血清學指標。同時患者應用 FibroScan 進行肝髒彈性測量值（LSM）測量，分析 LSM 與肝纖維化的相關性及其影響因素。結果以肝髒穿刺病理結果為金標準， Spearman 等級相關性分析提示 LSM 與肝纖維化呈顯著相關性（P <0.05）。單因素方差分析提示天門鼕氨痠氨基轉移酶、堿性燐痠酶、血小闆、凝血酶原時間百分活動度與 LSM值呈相關性。受試者工作特性麯線（ROC）分析，S2~ S4期診斷界值依次為6.0、9.75、14.2 kPa，各階段麯線下麵積均>0.95。雙變量分析提示 LSM 值與升高的轉氨酶呈顯著相關性（P <0.05）。ROC 分析轉氨酶升高組 S1~ S2期界值為6.25 kPa，S3~ S4期界值為15.3 kPa。結論 FibroScan 診斷CHB 患者肝髒纖維化有較高的臨床應用價值，但是受轉氨酶影響大。
목적：평고순시탄성초성성상（FibroScan）재만성을형간염（CHB）환자간장섬유화진단중적림상응용개치。방법선취진행간장천자활검적 CHB 환자185례，수집혈상규、간공능등혈청학지표。동시환자응용 FibroScan 진행간장탄성측량치（LSM）측량，분석 LSM 여간섬유화적상관성급기영향인소。결과이간장천자병리결과위금표준， Spearman 등급상관성분석제시 LSM 여간섬유화정현저상관성（P <0.05）。단인소방차분석제시천문동안산안기전이매、감성린산매、혈소판、응혈매원시간백분활동도여 LSM치정상관성。수시자공작특성곡선（ROC）분석，S2~ S4기진단계치의차위6.0、9.75、14.2 kPa，각계단곡선하면적균>0.95。쌍변량분석제시 LSM 치여승고적전안매정현저상관성（P <0.05）。ROC 분석전안매승고조 S1~ S2기계치위6.25 kPa，S3~ S4기계치위15.3 kPa。결론 FibroScan 진단CHB 환자간장섬유화유교고적림상응용개치，단시수전안매영향대。
Objective To evaluate the clinical value of FibroScan in the diagnosis of liver fibrosis in patients with chronic hepatitis B(CHB). Methods A total of 185 patients diagnosed with CHB based on pathological examina-tions were collected,while other biochemical markers were determined as well. Besides,FibroScan was used for all patients to detect liver stiffness measurement(LSM). The receive operating characteristic(ROC)curve was used to analyze the accuracy of FibroScan in the diagnosis of liver fibrosis in CHB patients. The relationships of LSM and biochemical markers were also analyzed. Results Compared with pathological examinations,FibroScan value was closely related with liver fibrosis(P < 0. 05). One-way ANOVA analysis indicated that AST,ALP,PLT and PT%were related with LSM value. ROC curve indicated the AUCs were all above 0. 95 for CHB patients with liver fibro-sis stages S2 ~ S4 and the cut-off values were 6. 0,9. 75 and 14. 2 kPa,respectively. Bivariate analysis indicated LSM value was related to up-regulated transaminase(P < 0. 05). ROC curve revealed the cut-off values of stage S1~ S2 was 6. 25 and 15. 3 kPa for stage S3 ~ S4 in CHB patients with transaminase abnormality. Conclusion Fi-broScan is valuable for the diagnosis of liver fibrosis in CHB patients,but limited by transaminase abnormality.
