首 页   本刊简介  编委会  审稿专家  在线期刊  写作规范  广告合作  联系我们
您现在的位置:首页 => 在线期刊 => 2016年 8期 => 肝纤维化及肝硬化 =>3种无创诊断技术对慢性乙型肝炎肝..
3种无创诊断技术对慢性乙型肝炎肝纤维化的评估价值比较
The predictive values of three noninvasive indices in diagnosis of liver fibrosis in patients with chronic hepatitis B: a comparative study
文章发布日期:2016年07月06日  来源:  作者:庄小芳,马燕,王晓忠,等  点击次数:1558次  下载次数:301次

调整字体大小:

(此处下载失败可以在在线预览处保存副本或者右键另存为)

【摘要】:目的探讨FibroTouch、FIB-4指数、APRI指数3种肝纤维化无创诊断技术对慢性乙型肝炎(CHB)肝纤维化评估的价值。方法纳入2013年9月-2015年5月在新疆维吾尔自治区中医医院就诊的148例行肝穿刺活组织检查的CHB 患者,以肝纤维化分期分组,均进行血生化、血常规、FibroTouch检测,计算FIB-4指数和APRI指数,记录肝脏硬度值,应用受试者工作特征曲线(ROC)分析方法计算曲线下面积(AUC),确定截断值、敏感度和特异度。两组间比较采用χ2检验;相关性检验采用Pearson等级相关分析。结果FibroTouch、APRI和FIB-4指数3种无创诊断方法与肝纤维化分期具有良好的相关性(r值分别为0.628、0.486、0.482,P值均<0.01)。 FibroTouch对明显肝纤维化组(≥S2)、肝硬化组(S4)的诊断性能最好,AUC分别为0.84、093;其次为APRI指数,AUC分别为0.79、0.87;FIB-4 指数诊断性能相对较差,AUC分别为0.77、0.84。对于肝纤维化分期≥S2及S4,FibroTouch诊断价值均优于APRI及FIB-4指数(Z=21.589,P<0.001;Z=18.896,P<0.001;Z=11.192,P=0.001;Z=16.891,P<0001),APRI指数诊断价值优于FIB-4指数(Z值分别为46.918、35.334,P值均<0.001)。结论FibroTouch可以较准确地评估CHB患者有无肝纤维化及肝纤维化程度,使多数患者避免有创性肝穿刺活组织检查。
【Abstract】:ObjectiveTo investigate the values of FibroTouch, FIB-4 index, and aspartate aminotransferase-to-platelet ratio index (APRI) in the diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB). MethodsA total of 148 patients with CHB who visited Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region and underwent liver biopsy from September 2013 to May 2015 were enrolled and divided into groups according to fibrosis stage. All the patients underwent blood biochemical examination, routine blood tests, and FibroTouch measurement. Then FIB-4 and APRI were calculated, and liver stiffness was recorded. The receiver operating characteristic (ROC) curve was used to calculate the area under the ROC curve (AUC) and determine the cut-off value, sensitivity, and specificity. Chi-square test was used for comparison between two groups, and the Pearson rank correlation analysis was also performed. ResultsFibroTouch, APRI, and FIB-4 were well correlated with fibrosis stage (r=0.628, 0.486, and 0482, respectively, all P<0.01). In the marked liver fibrosis (≥S2) group and liver cirrhosis (S4) group, FibroTouch had the best diagnostic performance, with AUCs of 0.84 and 0.93, respectively, followed by APRI, which had AUCs of 0.79 and 0.87, respectively; FIB-4 index had the worst diagnostic performance, with AUCs of 0.77 and 0.84, respectively. In patients with a fibrosis stage of ≥S2 or S4, FibroTouch had a better diagnostic value than APRI and FIB-4 (Z=21.589, P<0.001; Z=18.896, P<0.001; Z=11.192, P=0.001; Z=16.891, P<0.001), and APRI had a better diagnostic value than FIB-4 (Z=46.918, P<0.001; Z=35.334, P<0.001). ConclusionFibroTouch can accurately evaluate the presence of liver fibrosis and fibrosis degree and help most patients avoid invasive liver biopsy.
【关键字】:肝硬化; 肝炎, 乙型, 慢性; 诊断技术和方法; 对比研究
【Key words】:liver cirrhosis; hepatitis B, chronic; diagnostic techniques and procedures; comparative study
【引证本文】:庄小芳, 马燕, 王晓忠, 等. 3种无创诊断技术对慢性乙型肝炎肝纤维化的评估价值比较[J]. 临床肝胆病杂志, 2016, 32(8): 1508-1512.

地址:长春市东民主大街519号《临床肝胆病杂志》编辑部 邮编:130061 电话:0431-88782542/3542
临床肝胆病杂志 版权所有 Copyright © 2009 - 2013 Lcgdbzz.org. All Rights Reserv 吉ICP备10000617号

吉公网安备 22010402000041号