对乙肝肝硬化无创诊断方法基于潜变量模型的评价

发布时间：2018-01-26 19:26

本文关键词： 无创诊断 FibrScan APRI FIB-4 潜变量诊断评价　出处：《中南大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：乙肝肝硬化的诊断方法较多,尤其是无创诊断方法开展广泛。在临床应用和实践前,我们需对这些方法进行诊断评价,了解其诊断效能及应用范围。由于肝穿刺活检无法达到金标准的要求,既往以其为参考标准的诊断评价是不完美和有缺陷的。本研究旨在无金标准诊断方法做参考时,利用潜变量模型对几种无创诊断方法进行评价。方法：2013年6月～2014年3月间,对某三甲医院肝病科门诊的慢性病毒性乙型肝炎患者的临床数据进行收集。利用FibroScan, APRI,FIB-4和白球比四种无创诊断方法对纳入的575名患者进行肝硬化或肝纤维的诊断。以上临床数据和诊断评价结局为基础,用潜变量模型方法对其进行诊断评价,了解各诊断方法的诊断效能及特点。结果：随机效应的潜变量模型对本研究临床数据有较好的相适性,可以评价各诊断方法的的效能。诊断乙肝相关性进展期肝纤维化：APRI的特异性和敏感性分别是：99.41%和28.45%；FIB-4的特异性和敏感性分别是：99.35%和98.79%；FibroScan的特异性和敏感性分别是83.42%和55.9%。诊断乙肝相关性肝硬化：APRI的特异性和敏感性分别是：99.99%和19.32%；FIB-4的特异性和敏感性分别是：99.78%和90.23%；FibroSa的特异性和敏感性分别是93.31%和36.81%；白球比的特异性和敏感性分别是99.47%和3.4% 结论：随机效应潜变量模型在无金标准的前提下,对几种无创诊断方法的准确性进行评估,FIB-4和FibScan表现出较好的诊断价值。
[Abstract]:Objective: there are many diagnostic methods for hepatitis B cirrhosis, especially non-invasive diagnostic methods are widely used. Before clinical application and practice, we need to evaluate these methods. To understand its diagnostic efficacy and scope of application. Liver biopsy can not meet the requirements of gold standards. This study aims to evaluate several non-invasive diagnostic methods by using latent variable model as a reference. Methods: from June 2013 to March 2014, the clinical data of patients with chronic viral hepatitis B (CHB) in the Department of Hepatology of a third Grade A Hospital were collected and FibroScan was used. APRII-FIB-4 and white-ball ratio four noninvasive diagnostic methods were used to diagnose liver cirrhosis or hepatic fiber in 575 patients. The above clinical data and diagnostic evaluation results were based on the above clinical data. The latent variable model method is used to evaluate the diagnostic efficacy and characteristics of each diagnostic method. Results: the latent variable model of random effect has good compatibility to the clinical data of this study. The specificity and sensitivity of diagnosing Hepatitis B related advanced hepatic fibrosis: 1. The specificity and sensitivity were 99.41% and 28.45%, respectively. The specificity and sensitivity of FIB-4 were 99.35% and 98.79%, respectively. The specificity and sensitivity of FibroScan were 83.42% and 55.9, respectively. 99.99% and 19.32; The specificity and sensitivity of FIB-4 were 99.78% and 90.23%, respectively. The specificity and sensitivity of FibroSa were 93.31% and 36.81 respectively. The specificity and sensitivity of the white ball ratio were 99.47% and 3.4%, respectively. Conclusion: on the premise of no gold standard, the stochastic effect latent variable model can evaluate the accuracy of several noninvasive diagnostic methods. FIB-4 and FibScan have good diagnostic value.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.62

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