Fibroscan评价慢性病毒性肝炎肝纤维化(≥F2)的Meta分析  

Evaluation of hepatic fibrosis stage(≥ F2) by fibroscan in patients with chronic viral hepatitis: A Meta-analysis

作　　者：罗子华[1] 邹健[1] 宓林[1] 刘燕[1] 童依丽[1] 于晓峰[1] 

机构地区：[1]复旦大学附属华东医院消化内科,上海市200040

出　　处：《世界华人消化杂志》2013年第33期3724-3735,共12页World Chinese Journal of Digestology

摘　　要：目的:应用诊断试验Meta分析方法评价瞬时弹性成像技术(fibroscan,FS)诊断慢性病毒性肝炎肝纤维化的准确性以及研究其准确性是否受病因影响.方法:检索万方数据-学术期刊全文库、中国期刊全文数据库(Chinese Journal Full-Text Database,CJFD)、中国生物医学文献数据库(Chinese Biomedical Literature Database,C B M)、P u b M e d(M e d l i n e)、C o c h r a n e library、EMBASE数据库中有关FS评价慢性病毒性肝炎肝纤维化的中英文文献,进行严格筛选和评价,应用Meta-disc1.4和Stata12.0软件进行统计学分析.结果:共纳入28篇中英文文献.FS诊断慢性病毒性肝炎明显肝纤维化(≥F2)和肝硬化(F=4)的合并敏感度、合并特异度、合并诊断比值比、综合受试者工作特征(summary receiver operating characteristic,SROC)曲线下面积分别为0.72(0.70-0.73)、0.85(0.83-0.87)、18.51(13.28-25.80)、0.88和0.86(0.84-0.88)、0.86(0.85-0.87)、49.14(30.53-79.09)、0.94.Meta分析对所有慢性病毒性肝炎所得的结果,与按慢性丙型肝炎(chronic hepatitis C,CHC)或慢性乙型肝炎(chronic hepatitis B,CHB)病因分类后Meta分析所得的结果相比,未见明显差异.结论:FS诊断肝纤维化分级的准确性良好,尤其对诊断肝硬化.不论是CHC或CHB,FS诊断肝纤维化分级的准确性无明显差别.AIM： To evaluate the value of fibroscan （FS） in hepatic fibrosis stage assessment in patients with chronic viral hepatitis, and to examine whether its accuracy is affected by etiology. METHODS： English and Chinese articles re- lated to assessment of hepatic fibrosis stage by fibroscan in Wanfang, Chinese Journal Full-Text Database （CJFD）, Chinese Biomedical Literature Database （CBM）, PubMed, Cochrane library and EMBASE database were strictly screened and evaluated. Data of enrolled articles were ana- lyzed using Meta-discl.4 and Stata12.0 software. RESULTS： A total of 28 English and Chinese articles were included. The pooled sensitivity, specificity, diagnostic odds ratio and the areaunder curve （AUC） of summary receiver operat- ing characteristic （SROC） curve for significant fibrosis （F≥ 2） and cirrhosis （F = 4） in patients with chronic viral hepatitis were 0.72 （0.70-0.73）, 0.85 （0.83-0.87）, 18.51 （13.28-25.80）, 0.88 and 0.86 （0.84-0.88）, 0.86 （0.85-0.87）, 49.14 （30.53-79.09） and 0.94, respectively. There was no significant difference among the results of meta-analysis ac- cording to etiology. CONCLUSION： Fibroscan has a high diagnostic accuracy for evaluating hepatic fibrosis stage, es- pecially in patients with cirrhosis. The diagnostic accuracy of fibroscan is not affected by etiology.

关 键 词：FIBROSCAN 肝纤维化 META分析 慢性丙型肝炎 慢性乙型肝炎 

分 类 号：R575.2[医药卫生—消化系统]