实用肝脏病杂志2018，Vol.21Issue(2)：216-219,4.DOI:10.3969/j.issn.1672-5069.2018.02.015
声触诊组织量化联合天门冬氨酸氨基转移酶/血小板比值对慢性乙型肝炎患者肝纤维化分期的诊断价值研究
Diagnosis of liver fibrosis in patients with chronic hepatitis B by acoustic palpation tissue quantification and aspartate aminotransferase/platelet ratio
摘要
Abstract
Objective To investigate the diagnostic value of liver fibrosis staging in patients with chronic hepatitis B by acoustic palpation tissue quantification(VTQ)and aspartate aminotransferase/platelet ratio(APRI).Methods 103 patients with chronic hepatitis B between November 2014 and December 2016 in our hospital were included and all of them received liver biopsies. 36 healthy subjects were selected as controls. VTQ was performed in both groups,and APRI was calculated. The diagnostic efficacy was evaluated by ROC curve. Results The ages of 35 patients with F4 liver fibrotic staging was significantly older than those of healthy persons,20 with F1 and 19 with F3 liver fibrotic staging [(44.10±8.89)yr vs.(33.15±8.08)yr,(34.02±7.36)yr,(38.55±9.39)yr,P<0.05];the oblique diameter of right liver in patients with F4 staging was(121.51 ±8.61)mm,significantly shorter than(126.61 ±8.54)mm in healthy persons, (126.59±8.71)mm in with F1,(128.96±9.01)mm in with F2 and(128.88±8.66)mm in with F3 staging(P<0.05);the VTQ in F4 group was(1.89±0.39)m/s,much faster than (1.11±0.14)m/s in healthy persons,(1.29±0.26)m/s in F1,[(1.35 ±0.25)m/s in F2,(1.55 ±0.24)m/s in F3 staging(P<0.05);VTQ increased as the liver fibrosis got severe;the APRI in healthy persons was(0.16 ±0.06), significantly less than(0.23±0.15)in F1,(0.30±0.18)in F2,(0.30±0.18)in F3 and(0.45±0.46)in F4,and APRI increased as the liver fibrosis got severe(P<0.05);the stage of liver fibrosis was positively correlated with VTQ(95% Cl: 0.715~0.893,r=0.804,P<0.001),and was negatively correlated with APRI(95% Cl:0.583~0.781,r=0.681,P<0.001);the ROC analysis showed that the AUCs of VTQ and APRI in diagnosis of F1 were 0.873 and 0.811,of F2 were 0.882 and 0.861,and of F3 were 0.941 and 0.861,and of F4 were 0.940 and 0.817,suggesting that VTQ was superior to APRI,and the specificity and positive predictive value of VTQ were superior to the VTQ/APRI ratio or APRI in diagnosis of greater than F2 liver fibrosis. Conclusion The VTQ and APRI are associated with the staging of hepatic fibrosis in patients with chronic hepatitis B,and the VTQ and APRI have a good diagnostic efficacy for detecting liver fibrosis greater than F2 staging.关键词
慢性乙型肝炎/肝纤维化/声触诊组织量化/天门冬氨酸氨基转移酶/血小板比值/诊断Key words
Hepatitis B/Liver fibrosis/Acoustic tissue quantification/Aspartate aminotransferase/platelet ratio/Diagnosis引用本文复制引用
田婧,何岩莉,骈林萍,陈安萌,李墨航..声触诊组织量化联合天门冬氨酸氨基转移酶/血小板比值对慢性乙型肝炎患者肝纤维化分期的诊断价值研究[J].实用肝脏病杂志,2018,21(2):216-219,4.基金项目
河南省教育科学规划课题(编号:2013-JKGHB—0098) （编号:2013-JKGHB—0098）
