安徽医科大学学报2017，Vol.52Issue(3)：430-434,5.DOI:10.19405/j.cnki.issn1000-1492.2017.03.028
瞬时弹性成像联合APRI和FIB-4指数模型无创诊断慢性HBV感染者肝纤维化的临床价值
Diagnostic value of transient elastography (FibroTouch) combined withAPRI and FIB-4 on liver fibrosis in patients with chronic hepatitis B
摘要
Abstract
Objectives To explore the clinical value of transient elastography (FibroTouch) combined with aspartame aminotransferase to platelet ratio index (APRI) and fibrosis index based on the 4 factor (FIB-4) on liver fibrosis in patients with chronic hepatitis B.Methods The severity of liver fibrosis in 265 chronic hepatitis B patients was assessed by liver biopsy and liver stiffness measurement(LSM) was checked by FibroTouch;routine laboratory indicators were examined to calculate APRI and FIB-4 index.The diagnostic value of FibroTouch, APRI and FIB-4 index in significant fibrosis, advanced fibrosis and cirrhosis were assessed according to the area under the receiver operating characteristic curves (ROC).APRI and FIB-4 index were combined with LSM to evaluate the liver fibrosis degree of patients with chronic hepatitis B respectively and calculated the sensitivity(SN), specificity(SP) et al.Results With the increase of liver fibrosis, the value of LSM (rs=0.622, P<0.001) had higher correlation than APRI and FIB-4 indexes in liver fibrosis stage.Diagnosis of 265 chronic HBV patients, the area under ROC curve of FibroTouch for significant fibrosis(≥S2), advanced fibrosis(≥S3) and cirrhosis(S=4) were 0.810, 0.881 and 0.961 respectively, which were significantly higher than APRI and FIB-4 index.The cutoff value of FibroTouch, APRI and FIB-4 index in significant fibrosis(≥S2), advanced fibrosis(≥S3) and cirrhosis(S=4) were obtained according to the area under the ROC cure.The sensitivity and specificity of FibroTouch on any hepatic fibrosis stage were all better than APRI and FIB-4.FibroTouch was combined with APRI or FIB-4 indexs respectively;parallel test improved the sensitivity of diagnosis.The value of sensitivity was more than 91.11% when FibroTouch combined with APRI by the parallel test respectively and the sensitivity also increased obviously when combined with FIB-4.However, the specificity of diagnosis had a significant improvement by serial test.The value of specificity was more than 94.42% when FibroTouch was combined with APRI by the serial test respectively.Conclusion The sensitivity and specificity of FibroTouch on diagnosis of hepatic fibrosis are all better than APRI and FIB-4.In the noninvasive diagnosis of liver fibrosis, each of their combinations is better than that of the individual.关键词
瞬时弹性成像/FIB-4/APRI/肝纤维化/无创诊断Key words
transient elastography/FIB-4 index/APRI index/liver cirrhosis/non-invasive diagnosis分类
医药卫生引用本文复制引用
代倩,李晶晶,马双双,郜玉峰,叶珺,邹桂舟..瞬时弹性成像联合APRI和FIB-4指数模型无创诊断慢性HBV感染者肝纤维化的临床价值[J].安徽医科大学学报,2017,52(3):430-434,5.基金项目
安徽省自然科学基金(编号:1608085MH164) （编号:1608085MH164）
