慢性乙型肝炎疾病进展中瞬时弹性波检测的意义及其影响因素

doi:10.6040/j.issn.1671-7554.0.2013.332

山东大学学报（医学版） ›› 2014, Vol. 52 ›› Issue (1): 85-88.doi: 10.6040/j.issn.1671-7554.0.2013.332

慢性乙型肝炎疾病进展中瞬时弹性波检测的意义及其影响因素

刘伟1，丁艾昆2，李程2，单容3，王昌源1,2

1. 山东大学医学院，济南 250012； 2. 济南市传染病医院七科，济南 250021；
3. 济南市传染病医院超声诊断科，济南 250021

收稿日期:2013-05-21 出版日期:2014-01-10 发布日期:2014-01-10
通讯作者: 王昌源，Email: wangcy5440@163.com

Significance and influential factors of Fibroscan detection in the progress of patients with chronic hepatitis B disease

LIU Wei1, DING Ai-kun2, LI Cheng2, SHAN Rong3, WANG Chang-yuan1,2

1. School of Medicine, Shandong University, Jinan 250012, China;
2. Seventh Department of Jinan Infectious Disease Hospital, Jinan 250021, China;
3. Department of Ultrasound, Jinan Infectious Disease Hospital, Jinan 250021, China

Received:2013-05-21 Online:2014-01-10 Published:2014-01-10

摘要/Abstract

摘要：

目的探讨瞬时弹性波检测(Fibroscan，FS)对慢性乙型肝炎患者疾病进展的评价作用及影响因素。方法收集660例FS检测的慢性乙型肝炎患者临床资料和其中96进行肝组织活检的病理结果，分析各临床指标对FS值（硬度值）的影响。根据肝脏病理纤维化分期进行分类，绘制不同纤维化分期FS值的受试者工作特征曲线(ROC)，计算曲线下面积(AUC)。结果不同性别、年龄、PLT、PTA、ALT、TBIL、ALB、门脉内径和脾脏厚度水平的FS值有差异（P<0.05）。多元线性逐步回归分析显示，ALT、PTA、ALB、脾脏厚度、门静脉内径、PLT、TBIL与FS值相关，其对FS值的影响依次减弱。肝纤维化轻度(S1)18例、中度(S2)39例、重度(S3)12例和肝硬化(S4)27例的AUC分别为0.724、0.832、0.836和0.798，诊断的界值分别为9.8、10.5、12.3和14.8kPa。结论 FS与肝脏病理纤维化分期符合率高，是评估慢性乙型肝炎疾病进展有价值的无创检查方法。

关键词: 肝脏硬度, 慢性乙型肝炎, 瞬时弹性波检测, 肝纤维化, 肝硬化

Abstract:

Objective To explore the evaluation effect and analyze the influential factors of Fibroscan (FS) detection in the progress of patients with chronic hepatitis B disease. Methods Six hundred and sixty patients with chronic hepatitis B disease were detected with Fibroscan and their clinical data were collected, and 96 of them had liver biopsy Results . Influences of various clinical indicators on FS values were analyzed. The 96 cases were grouped based on their fibrosis stage in biopsy, the receiver-operating characteristic curves (ROC) of FS values were drawn and the areas under the curve (AUC) were calculated. Results Multiple clinical indexes, such as age, gender, PLT, PTA, ALT, TBIL, the inner diameter of portal vein and thickness of spleen were associated with FS value, and their differences between different levels had statistical significance(P<0.05). Multiple linear stepwise regression analysis showed that ALT, PTA, thickness of spleen, the inner diameter of portal vein, PLT and TBIL were correlated with FS value. According to the absolute value of the standard regression coefficient, the influence of these indicators on FS value decreased gradually. The AUCs of FS detection for 18 cases of mild (S1), 39 cases of moderate (S2), 12 cases of severe (S3) degree liver fibrosis and 27 cases of cirrhosis (S4) were 0.724, 0.832, 0.836 and 0.798, respectively, and the cut-off values for diagnosis of various degree of fibrosis and cirrhosis were 9.8, 10.5, 12.3 and 14.8 kPa, respectively. Conclusion Fibroscan detection has a high coincidence rate with liver pathological fibrosis stage. It is a very effective and noninvasive examination in assessing disease progression of patients with chronic hepatitis B disease.

Key words: Liver stiffness;Chronic hepatitis B, Fibroscan, Liver fibrosis, Liver cirrhosis

刘伟1，丁艾昆2，李程2，单容3，王昌源1,2. 慢性乙型肝炎疾病进展中瞬时弹性波检测的意义及其影响因素[J]. 山东大学学报（医学版）, 2014, 52(1): 85-88.

LIU Wei1, DING Ai-kun2, LI Cheng2, SHAN Rong3, WANG Chang-yuan1,2. Significance and influential factors of Fibroscan detection in the progress of patients with chronic hepatitis B disease[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(1): 85-88.

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慢性乙型肝炎疾病进展中瞬时弹性波检测的意义及其影响因素

Significance and influential factors of Fibroscan detection in the progress of patients with chronic hepatitis B disease

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