传染病信息
傳染病信息
전염병신식
INFECTIOUS DISEASE INFORMATION
2015年
4期
223-226
,共4页
贺希%杨硕%牛子长%汤汝佳%张达利%周霞%周双男%苏海滨%刘振文%张敏
賀希%楊碩%牛子長%湯汝佳%張達利%週霞%週雙男%囌海濱%劉振文%張敏
하희%양석%우자장%탕여가%장체리%주하%주쌍남%소해빈%류진문%장민
弹性显像技术%硬度%超声学%血清学%肝纤维化%肝移植
彈性顯像技術%硬度%超聲學%血清學%肝纖維化%肝移植
탄성현상기술%경도%초성학%혈청학%간섬유화%간이식
elasticity imaging techniques%hardness%ultrsonics%serology%liver fibrosis%liver transplantation
目的：评价肝脏瞬时弹性成像（FibroScan）及血清肝纤维化4项[透明质酸（HA）、层粘连蛋白（LN）、Ⅳ型胶原（Ⅳ-C）和血清Ⅲ型前胶原（PCⅢ）]对肝移植患者发生明显肝纤维化（F>2）的诊断价值。方法选择2013年2月28日—2014年7月8日在本院治疗的行经皮肝脏穿刺活体组织检查的肝移植和非肝移植慢性肝病患者各40例，进行FibroScan检查以及血清肝纤维化4项检测。将肝脏硬度测定（liver stiffness measurement, LSM）值和血清肝纤维化4项结果与病理检查的肝纤维化程度进行相关性分析，用受试者工作特征曲线（receiver-operating characteristic curve, ROC曲线）分析和评估LSM值和血清肝纤维化4项对肝移植患者明显肝纤维化的诊断价值。结果肝移植患者HA和LSM值与肝纤维化评分呈正相关， rs分别为0.689和0.782。HA和LSM值诊断肝移植患者明显纤维化的ROC曲线下面积分别为0.789和0.943。明显肝纤维化患者中，肝移植者的LSM值高于非肝移植患者（P<0.05）；无明显肝纤维化（F≤2）的患者中，肝移植者Ⅳ-C和PCⅢ低于非肝移植患者（P均<0.05）。结论 LSM值和血清HA与肝移植患者的肝纤维化评分呈正相关，它们对肝移植患者的明显肝纤维化具有一定的诊断价值。
目的：評價肝髒瞬時彈性成像（FibroScan）及血清肝纖維化4項[透明質痠（HA）、層粘連蛋白（LN）、Ⅳ型膠原（Ⅳ-C）和血清Ⅲ型前膠原（PCⅢ）]對肝移植患者髮生明顯肝纖維化（F>2）的診斷價值。方法選擇2013年2月28日—2014年7月8日在本院治療的行經皮肝髒穿刺活體組織檢查的肝移植和非肝移植慢性肝病患者各40例，進行FibroScan檢查以及血清肝纖維化4項檢測。將肝髒硬度測定（liver stiffness measurement, LSM）值和血清肝纖維化4項結果與病理檢查的肝纖維化程度進行相關性分析，用受試者工作特徵麯線（receiver-operating characteristic curve, ROC麯線）分析和評估LSM值和血清肝纖維化4項對肝移植患者明顯肝纖維化的診斷價值。結果肝移植患者HA和LSM值與肝纖維化評分呈正相關， rs分彆為0.689和0.782。HA和LSM值診斷肝移植患者明顯纖維化的ROC麯線下麵積分彆為0.789和0.943。明顯肝纖維化患者中，肝移植者的LSM值高于非肝移植患者（P<0.05）；無明顯肝纖維化（F≤2）的患者中，肝移植者Ⅳ-C和PCⅢ低于非肝移植患者（P均<0.05）。結論 LSM值和血清HA與肝移植患者的肝纖維化評分呈正相關，它們對肝移植患者的明顯肝纖維化具有一定的診斷價值。
목적：평개간장순시탄성성상（FibroScan）급혈청간섬유화4항[투명질산（HA）、층점련단백（LN）、Ⅳ형효원（Ⅳ-C）화혈청Ⅲ형전효원（PCⅢ）]대간이식환자발생명현간섬유화（F>2）적진단개치。방법선택2013년2월28일—2014년7월8일재본원치료적행경피간장천자활체조직검사적간이식화비간이식만성간병환자각40례，진행FibroScan검사이급혈청간섬유화4항검측。장간장경도측정（liver stiffness measurement, LSM）치화혈청간섬유화4항결과여병리검사적간섬유화정도진행상관성분석，용수시자공작특정곡선（receiver-operating characteristic curve, ROC곡선）분석화평고LSM치화혈청간섬유화4항대간이식환자명현간섬유화적진단개치。결과간이식환자HA화LSM치여간섬유화평분정정상관， rs분별위0.689화0.782。HA화LSM치진단간이식환자명현섬유화적ROC곡선하면적분별위0.789화0.943。명현간섬유화환자중，간이식자적LSM치고우비간이식환자（P<0.05）；무명현간섬유화（F≤2）적환자중，간이식자Ⅳ-C화PCⅢ저우비간이식환자（P균<0.05）。결론 LSM치화혈청HA여간이식환자적간섬유화평분정정상관，타문대간이식환자적명현간섬유화구유일정적진단개치。
Objective To evaluate the value of transient elastography (FibroScan) and four serologic markers of liver fibrosis [hyaluronic acid (HA), laminin (LN), collagen type IV (Ⅳ-C) and procollagen type Ⅲ(PCⅢ)] in diagnosis of significant liver fibrosis (F>2) in liver transplant patients. Methods A total of 80 patients with chronic liver disease, who had liver biopsy in our hospital from February 28, 2013 to July 8, 2014, were enrolled in the study, of whom 40 underwent liver transplantation and the others didn't. Liver stiffness was measured by FibroScan and the four serologic markers of liver fibrosis were detected. Correlations between the value of liv-er stiffness measurement (LSM) and the four serologic markers of liver fibrosis and liver fibrosis stages obtained by liver biopsy were ana-lyzed. Receiver-operating characteristic (ROC) curves were used to analyze and evaluate the diagnostic value of LSM by FibroScan and the four serologic markers for significa nt liver fibrosis in liver transplant patients. Results HA and LSM value in liver transplant pa-tients were positively correlated with Metavir fibrosis scores, with rs of 0.689 and 0.782, respectively. The areas under ROC curve of di-agnosing significant liver fibrosis with HA and LSM value in liver transplant patients were 0.789 and 0.943, respectively. In patients with significant liver fibrosis, LSM value of patients undergoing liver transplantation was significantly higher than that of patients without undergoing liver transplantation (P<0.05), while in patients with F≤2,Ⅳ-C and PCⅢof patients undergoing liver transplantation were significantly lower than those of patients without undergoing liver transplantation (P<0.05). Conclusions LSM value and HA have positive correlations with Metavir fibrosis scores in liver transplant patients, and can be used to diagnose significant liver fibrosis in liver transplant patients.
