使用FibroScan受控衰减参数评估慢性HBV感染者肝脏病损的病理对照研究

发布时间：2018-09-05 20:58

【摘要】：目的:探讨使用Fibro Scan受控衰减参数(Controlled attenuation parameters,CAP)无创定量评估慢性乙肝患者肝脏病损程度(肝组织炎症、纤维化和脂肪变)。材料方法:选取2013年9月-2015年1月底期间入住我院的80例慢性乙型病毒性肝炎患者,同时进行Fibro Scan超声波瞬时弹性成像测量CAP值及肝穿刺活检。运用t检验、相关性检验和ROC曲线分析验证CAP值评估肝损伤方法的敏感度和特异性。结果:慢性乙肝患者CAP值与肝组织炎症分级与纤维化分期呈显著性负相关(r=-0.34,p0.05),而CAP值与患者肝脏脂肪变程度分级呈明显正相关(r=0.4197,p0.01)。轻度和中重度的炎症、肝脂肪变的慢性乙肝患者之间的CAP值有显著差异性(p0.05)。以分级指数≥2作为诊断中重度炎症、纤维化和脂肪化的标准,CAP值与炎症指数、纤维化指数和脂肪变指数的ROC曲线下面积(AUC)分别为0.8405、0.8205、0.9101,表明CAP值能准确评估肝损伤。阈值分析表明,CAP值194 d B/m能将肝组织轻度和中重度炎症区分开,方法的敏感度和特异性,分别为81%和89%。以CAP值236 d B/m为诊断阈值,能将肝组织轻度和中重度纤维化区分开,方法敏感度和特异性分别为79%和85%。CAP阈值为267 d B/m能将肝组织轻度和中重度脂肪病变区分开,方法敏感度和特异性分别为85%和91%。结论:Fibro Scan CAP值能准确区分慢性乙肝患者肝组织轻度和中重度炎症、纤维化和肝脂肪变程度,可用于无创定量评价慢性乙肝患者肝脏病损程度。
[Abstract]:Objective: to evaluate the degree of liver lesion (inflammation, fibrosis and fatty degeneration) in patients with chronic hepatitis B by using Fibro Scan controlled attenuation parameter (Controlled attenuation parameters,CAP). Materials: 80 patients with chronic viral hepatitis B were selected from September, 2013 to January, 2015, and the CAP value and liver biopsy were measured by Fibro Scan. T test, correlation test and ROC curve analysis were used to verify the sensitivity and specificity of CAP value in evaluating liver injury. Results: there was a significant negative correlation between CAP and liver inflammation grade and fibrosis stage (r = -0.34, p 0.05), but a positive correlation between CAP value and hepatic steatosis grade (r = 0.4197, p 0.01). There was a significant difference in CAP between mild and moderate inflammation, liver fat and chronic hepatitis B patients (p0. 05). Using grading index 鈮，

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