中国全科医学2016，Vol.19Issue(25)：3039-3044,6.DOI:10.3969/j.issn.1007-9572.2016.25.008
瞬时弹性成像技术联合血清学指标对慢性乙型肝炎肝纤维化的诊断价值研究
Diagnostic Value of Transient Elastography Technology Combined with Serological Indicator for Liver Fibrosis in Patients with Chronic Hepatitis B
摘要
Abstract
Objective To evaluate the diagnostic value of transient elastography technology(FibroTouch)combined with serological indicator in liver fibrosis of patients with chronic hepatitis B. Methods 145 patients with chronic hepatitis B were selected from January to November in 2O15 in Xixi Hospital of Hangzhou. Liver stiffness( LSM) was detected by using FibroTouch,and alanine aminotransferase(ALT),aspartate transaminase( AST),total bilirubin( TBIL),prothrombintime (PT),blood platelet(PLT),four indicators of hepatic fibrosis〔 hyalaronic acid( HA),laminin( LN),type Ⅳ collagen (CⅣ),type Ⅲ collagen(PⅢNP)〕were detected,and AST/ ALT,APRI,FIB - 4 were also calculated. With the results of hepatic pathology as the golden standard,the diagnostic value of FibroTouch and the above indicators in liver fibrosis of patients with chronic hepatitis B was evaluated;the influencing factors of hepatic fibrosis were screened out by using multiple Logistic regression method,and the prediction probability was obtained,and the receiver operating characteristic( ROC)curve was established by combining with double normal model to evaluate the diagnostic value of combined diagnosis of liver fibrosis in patients with chronic hepatitis B. Results LSM,AST/ ALT,HA,LN,C Ⅳ,P Ⅲ NP,APRI and FIB - 4 had significant influence on liver fibrosis( P < O. O5);but ALT,AST,TBIL,PT,PLT had no significant on liver fibrosis( P > O. O5). LSM,AST/ ALT,HA,APRI and FIB - 4 were positively correlated with the stages of liver fibrosis(the values of rs was O. 735, O. 246,O. 56O,O. 238 and O. 378 respectively;P < O. O5). The area under the curve(AUC)of ROC curve of the evaluation of LSM,AST/ ALT,HA,APRI and FIB - 4 on liver fibrosis phase( S ≥2)was O. 888,O. 6O2,O. 798,O. 647 and O. 693 respectively;the AUC of liver fibrosis phase(S≥3)was O. 881,O. 637,O. 819,O. 654 and O. 7O2 respectively;the AUC of liver fibrosis phase( S4)was O. 876,O. 647,O. 735,O. 6O9 and O. 739 respectively. Multiple Logistic regression analysis showed that LSM and HA were the influencing factors of liver fibrosis. Therefore,the prediction probability was positively correlated with liver fibrosis staging(rs = O. 89O,P < O. O5),and the AUC of their evaluation on liver fibrosis staging(S≥2, S≥3,S4)was O. 934,O. 938 and O. 981 respectively. Conclusion FibroTouch combined with HA is a simple and convenient, noninvasive and efficient diagnostic method,which can significantly improve the clinical diagnosis of liver fibrosis in chronic hepatitis B.关键词
乙型肝炎/肝炎,慢性/肝硬化/瞬时弹性成像/血清学试验/诊断Key words
Hepatitis B/Hepatitis,chronic/Liver cirrhosis/Transient elastography/Serologic tests/Diagnosis分类
医药卫生引用本文复制引用
刘芳,魏琳,王珊珊,黄斌..瞬时弹性成像技术联合血清学指标对慢性乙型肝炎肝纤维化的诊断价值研究[J].中国全科医学,2016,19(25):3039-3044,6.基金项目
浙江省自然科学基金资助项目 （）
