FibroScan对慢性乙型肝炎肝纤维化患者的应用价值及ALT、AST对其诊断的影响

孝奇; 刘志权; 冯军花; 叶立红; 梅志勤; 李振燕; 杜瑞清; 戴二黑

FibroScan对慢性乙型肝炎肝纤维化患者的应用价值及ALT、AST对其诊断的影响

1. 石家庄市第五医院影像科
2. 石家庄市第五医院检验科
3. 河北医科大学第四医院检验科
4. 石家庄市第五医院超声科

基金项目:

河北省卫生厅科研指令性课题(编号08189)；

详细信息

中图分类号: R512.62
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出版历程
- 出版日期: 2012-09-20

Clinical value of FibroScan for detecting liver fibrosis in patients with chronic hepatitis B and effects of ALT and AST on diagnosis

Research funding:

摘要

摘要:
目的探讨瞬时弹性探测仪(FS)在慢性乙型肝炎肝纤维化患者中应用价值及ALT、AST对其诊断纤维化的影响。方法应用FS对90名慢性乙型肝炎肝纤维化患者进行肝穿前肝脏弹性测量值(LSM)的测定,同时进行血清ALT、AST的检测。以肝脏活检病理结果为金标准,对肝纤维化进行分期。结果 LSM在肝纤维化病理S1～4之间逐渐增高,组间差异有统计学意义(P<0.01);相邻两分期间LSM组间差异均有统计学意义(P<0.01)。肝脏LSM与病理分期呈正相关(r=0774,P<0.01)。S1～4各期的LSM与相应分期的ALT呈正相关,相关系数分别为0.672(P=0.000)、0.790(P=0.000)、0.845(P=0.001)和0.797(P=0.003),S1～4各期LSM与相应分期的AST呈正相关,相关系数分别为0.593(P=0.000)、0.762(P=0.001)、0.743(P=0.009)和0.872(P=0.000)。结论 FS在慢性乙型肝炎肝纤维化程度评估中有较好的应用价值,但是血清ALT和AST水平对其有一定影响。
- 瞬时弹性探测仪 /
- 肝炎,乙型,慢性 /
- 肝硬化
Abstract:
Objective To investigate the clinical value of FibroScan (Echosens SA, Paris, France) for detecting liver fibrosis in patients with chronic hepatitis B (CHB) and to investigate the effects of alanine aminotransferase (ALT) and asparatate aminotransferase (AST) on diagnosis. Methods Ninety CHB patients were enrolled in this study and underwent liver stiffness measurement (LSM) by FibroScan before liver biopsy. The levels of serum ALT and AST were detected via standard biochemical assays. Pathological stage of the liver fibrosis was determined by histology. Results The extent of LSM increased with increased extent of liver fibrosis, and the changes were significant between the groups (S1-S4, all P＜0.01). LSM was significantly positively related to the stage of liver fibrosis (Spearman correlation coefficient: 0.774, P＜0.01). LSM in patients with S1-S4 liver fibrosis was significantly positively related to the level of serum ALT (S1 coefficient: 0.672, P=0.000; S2 coefficient: 0.790, P=0.000; S3 coefficient: 0.845, P=0.001; and S4 coefficient: 0.797, P=0.003) and to the level of serum AST (S1 coefficient: 0.593, P=0.000; S2 coefficient: 0.762, P=0.001; S3 coefficient: 0.743, P=0.009; and S4 coefficient: 0.872, P=0.000). Conclusion FibroScan has very good clinical value for diagnosing liver fibrosis in patients with chronic hepatitis B, but may be affected by the level of serum ALT and AST.