FibroScan诊断不同类型慢性肝病肝纤维化的效果比较

陆海英; 刘玲峰; 徐小元; 于岩岩; 吴赤红

doi:10.3969/j.issn.1001-5256.2016.08.016

FibroScan诊断不同类型慢性肝病肝纤维化的效果比较

DOI: 10.3969/j.issn.1001-5256.2016.08.016

1. 北京大学第一医院
2. 北京阜外医院

基金项目:

国家十二五科技重大专项资助项目(2012ZX10002003;2013ZX10002004)；

详细信息

中图分类号: R575.2
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出版历程
- 收稿日期: 2016-02-29
- 出版日期: 2016-08-20

Fibro Scan in diagnosis of liver fibrosis in patients with different chronic liver diseases: a comparative analysis

Peking University First Hospital

Research funding:

摘要

摘要: 目的比较Fibro Scan诊断不同类型慢性肝病肝纤维化的异同性。方法收集2012年10月-2015年1月就诊于北京大学第一医院的516例慢性肝病患者的临床资料,按照病因分为慢性乙型肝炎（CHB）组（n=305）、慢性丙型肝炎（CHC）组（n=117）及原发性胆汁性肝硬化（PBC）组（n=94）,记录所有患者血常规、肝功能、肝脏弹性（FS）值以及腹部B超检查结果。按照FS值<7.3 k Pa、7.3 k Pa≤FS值<15 k Pa、FS值≥15 k Pa将每组患者分为不同的FS等级。计量资料和计数资料多组间比较采用KruskalWallis H检验,两组间比较采用Mann-Whitney U检验;FS值与年龄、性别、BMI、血常规、肝功能、超声各指标的相关性采用多重线性回归方法进行分析。结果 CHB组患者FS值的独立影响因素为性别、血红蛋白、AST、白蛋白、ALP、TBil、BMI、门静脉内径、腹水（P值均<0.05）;CHC组患者FS值的独立影响因素为血小板、ALT、ALP、GGT、总胆汁酸、肝表面光滑度、脾静脉内径、腹水（P值均<0.05）;PBC组患者F...
- 肝硬化 /
- 肝炎,乙型,慢性 /
- 肝炎,丙型,慢性 /
- 肝硬化,胆汁性 /
- 弹性成像技术 /
- 对比研究
Abstract: Objective To investigate the similarities and differences of Fibro Scan in the diagnosis of liver fibrosis in patients with different chronic liver diseases. Methods The clinical data of 516 patients with chronic liver diseases who visited Peking University First Hospital from October 2012 to January 2015 were collected,and according to the cause of disease,these patients were divided into chronic hepatitis B( CHB) group( 305 patients),chronic hepatitis C( CHC) group( 117 patients),and primary biliary cirrhosis( PBC) group( 94 patients). The routine blood test results,liver function,Fibro Scan( FS) value,and abdominal ultrasound findings were recorded. The patients in each group were further divided into subgroups with FS value < 7. 3 k Pa,7. 3 k Pa ≤FS value < 15 k Pa,or FS value ≥15 k Pa.The Kruskal- Wallis H test was used for comparison of continuous data and categorical data between multiple groups,and the Mann- Whitney U test was used for comparison between any two groups. The multiple linear regression was used to analyze the correlation of FS value with age,sex,body mass index( BMI),routine blood test results,liver function,and ultrasound parameters. Results In the CHB group,sex,hemoglobin,aspartate aminotransferase( AST),albumin,alkaline phosphatase( ALP),total bilirubin( TBil),BMI,diameter of the portal vein,and ascites were the independent influencing factors for FS value( all P < 0. 05); in the CHC group,platelet count,alanine aminotransferase( ALT),ALP,gamma- glutamyl transpeptidase( GGT),total bile acid,smoothness of liver surface,diameter of the portal vein,and ascites were the independent influencing factors for FS value( all P < 0. 05); in the PBC group,TBil,total bile acid,and ascites were the independent influencing factors for FS value( all P < 0. 05). Most indicators showed significant differences between CHB and CHC patients with different FS values( all P < 0. 05). In the PBC group,only ALT( Z =- 2. 121,P = 0. 034),AST( Z =- 3. 027,P =0. 002),and spleen length( Z =- 2. 496,P = 0. 013) showed significant differences between the FS value < 7. 3 k Pa subgroup and the7. 3 k Pa ≤FS value < 15 k Pa subgroup; platelet count( Z =- 2. 289,P = 0. 022),albumin( Z =- 2. 185,P = 0. 029),TBil( Z =- 2. 642,P = 0. 008),spleen thickness( Z =- 3. 317,P = 0. 001),spleen length( Z =- 2. 010,P = 0. 044),and diameter of the splenic vein( Z =- 2. 296,P = 0. 022) showed significant differences between the 7. 3 k Pa ≤FS value < 15 k Pa subgroup and the FS value ≥15 k Pa subgroup. Conclusion Different factors affect the FS value in patients with different causes. Total bile acid and TBil are important influencing factors for FS value in PBC patients,while liver function greatly influences FS value in CHB and CHC patients,suggesting that the threshold values for Fibro Scan in the diagnosis of liver fibrosis should be set independently for different causes of disease.
- liver cirrhosis /
- hepatitis B /
- chronic /
- hepatitis C /
- chronic /
- liver cirrhosis

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参考文献(15)

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