肝脏FibroScan测定和功能评分与肝硬化病理分级的相关性  

Correlation between liver functional scores,FibroScan measurement and histological subclassification of cirrhosis

作　　者：李继业[1] 王薇[1] 潘润华[1] 阿斯楞[1] 廖彩仙[1] 

机构地区：[1]南方医科大学南方医院肝胆外科,广东广州510515

出　　处：《山东大学学报（医学版）》2014年第12期83-88,共6页Journal of Shandong University:Health Sciences

基　　金：南方医科大学南方医院与恒丰实业集团有限公司合作科研项目(肝硬化程度的活体定量评估与临床分级研究)

摘　　要：目的探讨肝脏FibroScan测定和功能评分与肝硬化病理分级的相关性。方法回顾60例肝硬化患者的肝脏穿刺活检病理切片及临床资料,运用Laennec分级系统对病理切片进行组织学分级,分析肝脏FibroScan测定值和功能评分与肝硬化病理分级的相关性。结果病理分级为肝硬化轻度组27例(45%)、中度组21例(35%)、重度组12例(20%)。肝硬化轻、中、重度组的肝脏FibroScan测定值分别为(14.90±5.54)、(25.23±10.11)、(33.99±13.55)k Pa,三组间的差异具有统计学意义(P<0.05);肝脏FibroScan测定值用于判断中重度肝硬化和重度肝硬化的ROC曲线下面积分别为0.908、0.865。肝硬化轻、中、重度组的Child-Pugh评分分别为5.61±1.14、6.05±1.21、5.74±0.93,三组间的差异无统计学意义(P>0.05);肝硬化轻、中、重度组的M ELD评分分别为5.90±4.22、7.14±5.33、7.03±5.13,三组间的差异无统计学意义(P>0.05)。结论 FibroScan在诊断肝硬化严重程度方面有一定的应用价值;肝硬化程度与肝脏功能评分无显著相关性。Objective To investigate the relationship between histological subclassification of cirrhosis and liver func- tional scores as well as FibroScan transient elastography. Methods Clinical data of 60 biopsy-proven cirrhosis cases with different severity were collected and respectively reviewed. The liver functional scores and FibroScan values were assessed. Histology of cirrhosis was blindly subclassified using the Laennec fibrosis scoring system semi-quantitatively. Results Sixty cases were classified into 3 groups： mild cirrhosis group（ n = 27, 45 % ）, moderate cirrhosis group（n = 21, 35% ） and severe cirrhosis group（ n = 12, 20% ）. FibroScan values of mild, moderate and severe cirrhosis groups were （ 14.90±5.54）, （25.23±10.11 ） and （33.99 ±13.55）kPa, respectively, with significant difference among the groups （P 〈0.05）. The areas under the receiver operating characteristic （ROC） curve of FibroScan were 0.908 for moderate to severe cirrhosis, and 0.865 for severe cirrhosis. Child-Pugh scores of the three groups were 5.61±1.14, 6.05± 1.21 and 5.74 ±0.93, respectively, with no significant difference among them （ P 〉 0.05 ）. MELD scores of the three groups were 5.90 ± 4.22, 7.14±5.33 and 7.03 ±5.13, respectively, with no significant difference （ P 〉 0.05）. Conclusion FibroScan is a valuable examination for liver cirrhosis. There is no correlation between liver functional scores and histological subclassification of cirrhosis.

关 键 词：肝硬化 病理分级 肝脏弹性值 CHILD-PUGH评分 MELD评分 

分 类 号：R657.3[医药卫生—外科学]