Fibroscan硬度值测量联合超声影像参数对慢性乙型肝炎纤维化的诊断价值  被引量:7

Diagnostic value of Fibroscan stiffness measurement combined with ultrasound image parameter for chronic hepatitis B fibrosis

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作  者:胡素玲 栗红江 何久胜 刘震霞 HU Su-ling;LI Hong-jiang;HE Jiu-sheng(Functional Department,Baoding People's Hospital,Baoding 071000,China;不详)

机构地区:[1]保定市人民医院功能科,河北保定071000 [2]保定市人民医院肝六科,河北保定071000 [3]保定市中心血站检验科,河北保定071000 [4]保定市人民医院科教科,河北保定071000

出  处:《中国医学装备》2020年第11期73-77,共5页China Medical Equipment

基  金:河北省卫计委科研课题(20150708)“超声助显剂对胃肠道病变的争端价值及其拓展应用”;保定市科学技术科研课题(1951ZF005)“彩色多普勒超声联合Fibroscan评分系统在慢性乙肝纤维化诊断中的应用研究”。

摘  要:目的:探讨Fibroscan硬度值测量联合超声影像参数对慢性乙型肝炎(慢性乙肝)纤维化的诊断价值。方法:选取医院收治的205例接受肝穿刺的慢性乙肝患者,根据肝脏组织活检病理检查结果将其分为肝纤维化组(118例)和无肝纤维化组(87例)。采用Fibroscan检测肝脏硬度值(LSM值),彩色多普勒超声诊断仪检测患者肝脏各项指标,根据指标综合积分法对图像进行半定量化评分(被膜评分、静脉评分、实质评分、边缘评分和总评分);采用酶联免疫吸附(ELISA)法检测患者血清Ⅲ型前胶原氨基末端前肽(PⅢNP)、层黏连蛋白(LN)、透明质酸(HA)、IV型胶原(IV-C)等肝纤维化指标;分析肝纤维化患者Fibroscan硬度值、超声参数与肝纤维化指标的相关性。结果:肝纤维化组LSM值、被膜评分、静脉评分、实质评分、边缘评分、总评分、PIIINP、LN、HA及IV-C水平均高于无肝纤维化组,差异有统计学意义(t=9.908,t=10.392,t=6.626,t=7.329,t=6.617,t=9.339,t=10.009,t=7.629,t=27.324,t=22.633;P<0.05);肝纤维化患者LSM值、超声参数与肝纤维化指标均呈正相关;LSM值、被膜评分、静脉评分、实质评分、边缘评分和总评分诊断肝纤维化的曲线下面积(AUC)分别为0.861、0.873、0.715、0.787、0.682和0.819,特异度分别为93.1%、85.1%、88.5%、56.3%、63.2%和93.1%,灵敏度分别为62.7%、76.3%、50.0%、87.3%、65.3%和61.9%;联合诊断肝纤维化的AUC为0.998,特异度为98.9%,敏感度为93.2%。结论:Fibroscan硬度值及超声影像参数对慢性乙肝纤维化的诊断均有筛查和预警作用,具有一定临床诊断价值。Objective:To explore the diagnostic value of Fibroscan stiffness measurement combined with ultrasonic image parameters for chronic hepatitis B fibrosis.Methods:205 patients with chronic hepatitis B who received liver puncture were selected as the study objects.According to the pathological results of liver tissue biopsy,the patients were divided into liver fibrosis group(118 cases)and non-liver fibrosis group(87 cases).Fibroscan was used to detect the liver stiffness(LSM value),and all indexes of patients were detected by color Doppler ultrasonic diagnostic instrument.And according to the index integrated integral method,the images were scored semi quantitatively(capsule score,vein score,parenchyma score,marginal score and total score).And the levels of hepatic fibrosis indexes such as serum type III procollagen amino terminal pro peptide(PIIINP),laminin(LN),hyaluronic acid(HA)and type IV collagen(IV-C)were measured by enzyme-linked immunosorbent assay(ELISA).The correlations between Fibroscan stiffness values,ultrasound parameters and liver fibrosis index in patients with hepatic fibrosis were further analyzed.Results:The LSM value,capsule score,vein score,parenchyma score,marginal score,total score,and the levels of PIIINP,LN,HA,IV-C in liver fibrosis group were significantly higher than those in non-liver fibrosis group(t=9.908,t=10.392,t=6.626,t=7.329,t=6.617,t=9.339,t=10.009,t=7.629,t=27.324,t=22.633,P<0.05).The LSM value and ultrasonic parameters were positively correlated with the index of liver fibrosis in patients with liver fibrosis.The area under curves(AUC)of LSM value,capsule score,vein score,parenchyma score,marginal score and total score in diagnosing liver fibrosis were 0.861,0.873,0.715,0.787,0.682 and 0.819,and the specificities of them were 93.1%,85.1%,88.5%,56.3%,63.2%and 93.1%,and the sensitivities of them were 62.7%,76.3%,50.0%,87.3%,65.3%and 61.9%,respectively.The AUC,specificity and sensitivity of the combined diagnosis for liver fibrosis were 0.998,98.9%and 93.2%,respectively.Conclusion:F

关 键 词:Fibroscan硬度值 超声影像参数 慢性乙型肝炎 肝纤维化 诊断 

分 类 号:R445.1[医药卫生—影像医学与核医学]

 

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