FibroScan~实施受控衰减参数评价脂肪肝的影响因素及重复性分析  

Influencing factors and reproducibility of controlled attenuation parameters in the evaluation of fatty liver disease using FibroScan~

作　　者：沈峰[1] 徐正婕[1] 潘勤[1] 黄家懿[1] 陈光榆[2] 曹毅[1] 范建高[1] 

机构地区：[1]上海交通大学医学院附属新华医院消化内科,上海市200092 [2]上海交通大学医学院临床流行病学研究中心

出　　处：《实用肝脏病杂志》2013年第1期59-62,共4页Journal of Practical Hepatology

基　　金：中国肝炎防治基金会王宝恩肝纤维化研究基金(XJS20120501);国家重点基础研究发展计划项目(973计划;2012CB517501);上海交通大学医学院附属新华医院院长基金项目(12QYJ05)

摘　　要：目的评价瞬时弹性记录仪(FibroScan)实施受控衰减参数(CAP)无创定量诊断脂肪肝的影响因素及重复性。方法使用新型FibroScan-502机型及M探头对非酒精性脂肪性肝病(NAFLD)患者及对照人群进行肝脏脂肪含量(CAP值)测定。应用组内相关系数(ICC)评价重复测量的变异程度。结果 169例NAFLD患者和59例对照人群接受FibroScan检查,其中200例(87.7%)完成有效测量;肥胖组检查成功率显著低于体重正常组[75.0%(33/44)对93.9%(77/82),x2=9.548,P=0.02],女性、高龄和中心性肥胖者影响检查成功率;NAFLD组CAP值显著高于对照组(291.1±54.0dB/m对216.4±43.3dB/m,P<0.01);63例NAFLD患者进行CAP重复性测量提示同一操作者ICC为0.848(95%可信区间为0.761～0.905,P<0.01),不同操作者ICC为0.718(95%可信区间为0.607～0.896,P<0.01)。结论 FibroScan新参数CAP可用于脂肪肝的无创诊断,但肥胖症影响其测量成功率。Objective To evaluate the influencing factors and reproducibility of controlled attenuation parameters （CAP）measurement of fatty liver using FibroScan. Methods Patients with non-alcohol fatty liver disease（ NAFLD ）and normal controls were recruited to complete the CAP measurement with new FibroScan-502 and M probe. In NAFLD groups,some subjects were repeatedly checked-up by the same or different operator. Intraclass correlation coefficient （ICC）was used to evaluate the reproducibility of the operation. Results A total of 228 subjects were recruited, and 200 subjects（ 87.7% ）got the valid measurement;the success rates in normal and obese persons were 93.9%（77/82）and 75.0%（33/44,x2=9.548,P=0.02）,respectively;female,senior and obese persons had lower success of examination;CAP values in NAFLD group was 291.1±54.0 dB/m,significantly higher than that in control groups（216.4±43.3dB/m,P〈0.01）;The ICC was 0.848（95% CI 0.761±0.905,P〈0.01 ）with same operator and 0.718 （95% CI 0.607±0.896,P〈0.01 ）with different operator. Conclusion The CAP can be used for non-invasive diagnosis of fatty liver,with a good reproducibility.

关 键 词：非酒精性脂肪性肝病 瞬时弹性记录仪 受控衰减参数 无创诊断 

分 类 号：R575.5[医药卫生—消化系统]