瞬时弹性成像技术对自身免疫性肝病肝纤维化分期诊断价值的Meta分析  

Diagnostic value of transient elastography in the staging of hepatic fibrosis in patients with autoimmune liver disease:A Meta-analysis

作　　者：杨志然 王林恒[2] 李园 刘福生[3] 王雨 王建芳[2] 陈润花[2] YANG Zhiran;WANG Linheng;LI Yuan;LIU Fusheng;WANG Yu;WANG Jianfang;CHEN Runhuaa(The Second Clinical Medical College of Beijing University of Chinese Medicine,Beijing 100029,China;Department of Spleen-stomach,Liver-gallbladder,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Emergency Department,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学第二临床医学院,北京100029 [2]北京中医药大学东方医院脾胃肝胆科,北京100078 [3]北京中医药大学东方医院急诊科,北京100078

出　　处：《临床肝胆病杂志》2022年第1期97-103,共7页Journal of Clinical Hepatology

摘　　要：目的系统评价瞬时弹性成像技术(TE)对自身免疫性肝病肝纤维化分期的诊断价值。方法系统检索PubMed、Embase、Cochrane Library、中国知网、万方、维普数据库中已发表的关于TE诊断自身免疫性肝病肝纤维化分期的中、英文文献,检索时限为2000年1月—2021年1月,由2位评价员对纳入文献进行数据提取,采用文献质量评价工具QUADAS2进行文献质量评价,并应用Stata 15.0软件中双变量混合效应模型进行Meta分析。结果纳入11篇文献,共1041例患者。TE诊断显著肝纤维化(≥F2)的合并敏感度、特异度和AUC分别为0.81(95%CI:0.75~0.86)、0.87(95%CI:0.79~0.92)和0.91(95%CI:0.88~0.93),诊断进展期肝纤维化(≥F3)的合并敏感度、特异度和AUC分别为0.81(95%CI:0.74~0.87)、0.90(95%CI:0.85~0.93)和0.92(95%CI:0.90~0.94),诊断早期肝硬化(F4)的合并敏感度、特异度和AUC分别为0.87(95%CI:0.74~0.93)、0.93(95%CI:0.87~0.97)和0.96(95%CI:0.94~0.97)。结论TE对于评估自身免疫性肝病显著肝纤维化、进展期肝纤维化以及早期肝硬化均具有较好的诊断价值,尤其是对早期肝硬化的诊断准确度较高。Objective To investigate the value of transient elastography(TE)in the staging of hepatic fibrosis in patients with autoimmune liver disease(ALD).Methods PubMed,Embase,the Cochrane Library,CNKI,Wanfang Data,and VIP databases were searched for English and Chinese articles on TE in the staging of hepatic fibrosis in ALD published from January 2000 to January 2021.Two reviewers independently performed data extraction for the articles included,and QUADAS2 was used for quality assessment.The bivariate mixed effects model in Stata 15.0 software was used to perform the Meta-analysis.Results A total of 11 articles were included,with 1041 patients in total.In the diagnosis of significant hepatic fibrosis(F≥2),TE had a pooled sensitivity of 0.81(95%CI:0.75-0.86),a specificity of 0.87(95%CI:0.79-0.92),and an area under the receiver operating characteristic curve(AUC)of 0.91(95%CI:0.88-0.93);in the diagnosis of advanced hepatic fibrosis(F≥3),TE had a pooled sensitivity of 0.81(95%CI:0.74-0.87),a sensitivity of 0.90(95%CI:0.85-0.93),and an AUC of 0.92(95%CI:0.90-0.94);in the diagnosis of early-stage liver cirrhosis(F4),TE had a pooled sensitivity of 0.87(95%CI:0.74-0.93),a specificity of 0.93(95%CI:0.87-0.97),and an AUC of 0.96(95%CI:0.94-0.97).Conclusion TE has a good diagnostic value in evaluating significant liver fibrosis,advanced liver fibrosis,and early-stage liver cirrhosis in patients with ALD,especially with a relatively high diagnostic accuracy for early-stage liver cirrhosis.

关 键 词：肝硬化 自身免疫疾病 弹性成像技术 Meta分析(主题) 

分 类 号：R575.2[医药卫生—消化系统]