FibroTouch及FibroScan~实施受控衰减参数评价肝细胞脂肪变与肝脏病理比较分析  

Comparative analysis of controlled attenuation parameters in evaluation of liver steatosis using FibroTouch and FibroScan~

作　　者：朱梦飞[1] 刘静[1] 王洁[1] 陈公英[1] 娄国强[1] 施军平[1] 

机构地区：[1]杭州师范大学附属医院,杭州310015

出　　处：《中国实用内科杂志》2014年第6期589-593,共5页Chinese Journal of Practical Internal Medicine

基　　金：杭州市科技计划项目(20110833B07);杭州市卫生局项目(2011Z006)

摘　　要：目的评价瞬时弹性超声诊断仪FibroTouch、FibroScan实施受控衰减参数（CAP）无创定量诊断脂肪肝与肝脏穿刺病理结果的对比及相关分析。方法对2013年7—10月在杭州师范大学附属医院对病理确诊的非酒精性脂肪性肝病（NAFLD）患者及慢性乙型肝炎患者（CHB）应用FibroTouch、FibroScan-502机型测定肝脏脂肪含量（CAP值）。结果41例CHB患者与20例NAFLD患者同时接受FibroTouch、FibroScan检查，测定的CAP与患者体质量指数（BMI，r分别为0．42，0．61；P分别为0．02，0．000）及肝细胞脂肪变呈正相关（r分别为0．54，0．56；P均〈0．001）；33例病理诊断肝细胞脂肪变〉5％的患者FibroTouch与FibroScan测定的CAP值均显著高于28例无脂肪变的CAP值{FibroTouch：（252．18±41．23）dB／m比（220．68±54．75）dB／m，P=0．04；FibroScan：（291．61±56．80）dB／m比（215．75±45．11）dB／m，P=0．000]；FibroScan测定肝细胞脂肪变〈30％患者的CAP值、肝细胞脂肪变30％～60％患者的CAP值、〉60％脂肪变组的CAP值间存在差异（F=6．82，P=0．004），且肝细胞脂肪变〈30％患者的CAP值低于〉60％脂肪变组的CAP值[（258．73±52．54）dB／m比（327．42±49．08）dB／m，P=0．04]。但FibroTouch对上述3组患者测定的CAP值间差畀无统计学意义（F=2．30，P=0．12）。结论FibroTouch与Fi—broScan测定的CAP值均能评价肝细胞脂肪变，CAP值的高低与患者的BMI大小、肝病理脂肪变严重程度呈正相关。FibroScan测定的CAP值能区分轻度与重度的脂肪变，而FibroTouch测定的CAP值不能区分，可能与本组实验病例过少有关，有待进一步研究。Objective To compare the controlled attenuation parameters （CAP） measurement of liver steatosis using FibroTouch and FibroScan. Methods Patients with non-alcohol fatty liver disease （NAFLD） and chronic hepatitis B （CHB） were included from July to October 2013 and liver biopsy was completed on these patients. They were examined to collect the CAP values by FibroTouch and FibroSean-502 respectively. Results A total of 41 patients with CHB and 20 patients with NAFLD were recruited. CAP values of FibroScan and FibroTouch are positively correlated with BMI （r = 0.42,0. 61; P = 0. 02,0. 000） and degree of liver steatosis （r = 0. 54,0. 56;P = 0. 001,0. 001 ）. CAP values of 33 patients with 〉 5% fat degeneration of liver cells were significantly higher than those of patients with no fat degeneration （FibroTouch [252. 18 ±41.23]dB/m vs [220.68 ±54.75]dB/m,P =0.04;FibroScan[291.61 ±56.80] B/m vs [215.75± 45.11 ] dB/m ,P = 0. 000）. CAP values of patients with liver steatosis 〈 30% were significantly lower than those of patients with liver steatosis 〉 60% by FibroScan （ [ 258.73 -＋ 52. 54 ] dB/m vs [ 327.42 _＋ 49. 08 ] dB/m,P = 0. 04）. But there were no differences in CAP values among patients with liver steatosis less than 30% ,between 30% -60% ,and more than 60%. Conclusion CAP values by FibroTouch and FibroScan are positively correlated with body mass and degree of liver steatosis. CAP value is a good and noninvasive index to evaluate degree of liver steatosis.

关 键 词：瞬时弹性超声诊断仪 受控衰减参数 病理 肝细胞脂肪变 

分 类 号：R445.1[医药卫生—影像医学与核医学]