天津医药

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Fibroscan对慢性乙型肝炎肝脏纤维化的诊断价值

张旭1,王春妍2,3   

  1. 1. 天津医科大学研究生学院
    2.
    3. 天津市传染病医院
  • 收稿日期:2010-09-30 修回日期:2010-12-26 出版日期:2011-03-15 发布日期:2011-03-15
  • 通讯作者: 张旭

Validation of Fibroscan for liver fibrosis in chronic hepatitis B

  • Received:2010-09-30 Revised:2010-12-26 Published:2011-03-15 Online:2011-03-15

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摘要： 摘要：目的 探讨肝脏瞬时弹性探测仪即Fibroscan（简称FS）对慢性乙型肝炎肝脏纤维化的诊断价值。方法 对88例慢性乙型肝炎患者行FS检查，记录所检测到的肝硬度值。所有病例均于同期行肝穿刺活检。以肝活检病理结果为最佳标准绘制Fibroscan的受试者工作特征曲线,计算曲线下面积(AUC) ，评价其对慢性乙型肝炎肝脏纤维化的诊断价值。结果 FS对显著纤维化(S2～S4期) 、严重纤维化(S3～S4期)和早期肝硬化(S4期)的AUC值分别为0.857 (95%CI: 0.781～0.932, P =0.038)、0.934 (95%CI: 0.884～0.985, P =0.026)、0.948 (95%CI: 0.903～0.993, P=0.023)，以敏感度和特异度之和的最大值选定的最优cut-off值分别为7.25KPa、9.25 KPa、12.4 KPa。结论 FS可以较准确地估计慢性乙型肝炎患者纤维化程度,其中对严重纤维化(S3～S4期)及早期肝硬化(S4期)诊断价值优于显著纤维化(S2～S4期)，对乙型肝炎的诊断和治疗有重要指导意义。

关键词: 肝纤维化, 肝活检, 肝炎.乙型.慢性, Fibroscan

Abstract: Abstract：Objective To testify the diagnostic value of Fibroscan for liver fibrosis in patients with CHB. Methods 88 cases of chronic hepatitis B were enrolled.All of them underwent liver biopsy and liver stiffness measurement（LSM） by Fibroscan. With liver biopsy as the gold standard, ROC curves were delineated for different endpoints. The area under the ROC curves reflected its diagnostic values. Results The AUCs of Fibroscan for significant fibrosis, extensive fibrosis and cirrhosis were 0.857 (95%CI: 0.781～0.932, P =0.038)、0.934 (95%CI: 0.884～0.985, P =0.026)、0.948 (95%CI: 0.903～0.993, P=0.023) respectively.Optimal LSM cut-off values were7.25、9.25and12.4Kpa，respectively ，by maximizing the sum D of sensitivity and specificity。Conclusion Fibroscan is a reasonable noninvasive tool for the assessment of liver fibrosis，and appears to be reliable for detection of significant fibrosis or cirrohosis,which is of great importance in the diagnosis and treatment for CHB.

Key words: L iver fibrosis, L iver biopsy, Chronic hepatitis B, Fibroscan