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纤维化非酒精性脂肪性肝炎无创诊断的研究进展

冯巩 孔荣耀 王嘉学 吴天悦 武晓慧 王菊宁 严琴琴 弥曼

引用本文:
Citation:

纤维化非酒精性脂肪性肝炎无创诊断的研究进展

DOI: 10.12449/JCH241125
基金项目: 

陕西省教育厅项目 (23JK0646);

陕西省自然科学基础研究计划 (2023-JC-YB-699);

西安医学院科研能力提升计划项目 (2022NLTS098);

西安市科协青年人才托举计划 (959202413081)

利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:冯巩、孔荣耀、王嘉学、吴天悦负责课题设计,撰写论文;冯巩、王菊宁、孔荣耀、严琴琴、武晓慧负责论文的资料收集,资料分析和合作协调;冯巩、弥曼负责拟定写作思路,指导撰写文章并最后定稿。
详细信息
    通信作者:

    冯巩, 2543073495@qq.com (ORCID: 0000-0001-5394-0029)

    弥曼, 853002274@qq.com (ORCID: 0000-0001-7408-5113)

Research advances of noninvasive diagnosis of fibrotic non-alcoholic steatohepatitis

Research funding: 

Projects of Shaanxi Provincial Department of Education (23JK0646);

Natural Science Basic Research Program of Shaanxi (2023-JC-YB-699);

Xi’an Medical University Scientific Research Capacity Enhancement Program (2022NLTS098);

Young Talent Support Program of Xi’an City Association for Science and Technology (959202413081)

More Information
  • 摘要: 非酒精性脂肪性肝病(NAFLD)患者中有一部分可发展为非酒精性脂肪性肝炎(NASH),当NASH的纤维化程度F≥2且NAFLD活动度评分≥4时,该阶段的NASH被称为纤维化NASH,是药物临床试验中的重点关注对象。目前肝组织活检是评估肝组织学变化的金标准,但因其有创性限制了临床上的应用,因此开发纤维化NASH的非侵入性检测方法显得尤为重要。本文总结了近年来针对纤维化NASH的新型无创诊断方法的相关研究成果,阐述了新型诊断方法对纤维化NASH预测的现状、面临的挑战和未来的发展前景。

     

  • 表  1  AI辅助模型的临床参数及性能

    Table  1.   Clinical parameters and performance of AI-assisted models

    AI辅助模型 性能 敏感度 特异度 阳性预测值 阴性预测值
    ANN和CNN 诊断NAFLD 0.97(95%CI:0.76~1.00) 0.91(95%CI:0.78~0.97) 0.95(95%CI:0.87~0.98) 0.93(95%CI:0.80~0.98)
    AI辅助超声波检查 诊断NAFLD 0.97(95%CI:0.91~0.99) 0.98(95%CI:0.89~1.00) 0.98(95%CI:0.93~1.00) 0.95(95%CI:0.88~0.98)
    AI辅助临床数据 诊断NAFLD 0.75(95%CI:0.66~0.82) 0.82(95%CI:0.74~0.88) 0.75(95%CI:0.60~0.86) 0.82(95%CI:0.74~0.87)
    AI辅助超声检查、弹性成像、CT、MRI以及诊断肝纤维化和脂肪变性 诊断肝硬化 0.78(95%CI:0.71~0.85) 0.89(95%CI:0.81~0.94) 0.72(95%CI:0.58~0.83) 0.92 (95%CI:0.88~0.94)
    诊断进展性纤维化 0.86(95%CI:0.80~0.90) 0.87(95%CI:0.80~0.92) 0.85(95%CI:0.75~0.91) 0.88(95%CI:0.82~0.92)
    诊断显著纤维化 0.86(95%CI:0.78~0.92) 0.81(95%CI:0.77~0.84) 0.88(95%CI:0.80~0.93) 0.77(95%CI:0.58~0.89)
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  • 收稿日期:  2024-02-01
  • 录用日期:  2024-04-19
  • 出版日期:  2024-11-25
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