fECVs联合APRI对慢性丙型肝炎肝纤维化程度的评价  

Assessment of Liver Fibrosis in Chronic Hepatitis C by Hepatic Extracellular Volume Fractions Combined with AST/PLT Ratio Index

作　　者：梁占东[1] 刘燕霞 谢晋 邹殿俊[1] 刘兰 崔书君[1] LIANG Zhan-dong;LIU Yan-xia;XIE Jin;ZOU Dian-jun;LIU Lan;CUI Shu-jun(Department of Medical Imaing,the First Hospital Affiliated of Hebei North University,Zhangjiakou 075000,Hebei Province,China;Ultrasound Department,Zhangjiakou Infectious Diseases Hospital,Zhangjiakou 075000,Hebei Province,China)

机构地区：[1]河北北方学院附属第一医院医学影像部,河北张家口075000 [2]张家口市传染病医院超声科,河北张家口075000

出　　处：《中国CT和MRI杂志》2023年第6期113-115,124,共4页Chinese Journal of CT and MRI

基　　金：张家口市科学技术研究与发展计划项目(1911021D-5)。

摘　　要：目的探讨肝细胞外基质体积分数(fECVs)联合天门冬氨酸氨基转移酶与血小板比值指数(APRI)无创性评价慢性丙型肝炎(CHC)肝纤维化程度的诊断价值。方法回顾性分析120例CHC患者,均行肝脏增强CT及活检,并收集AST及PLT,得出fECVs和APRI。比较两种方法及联合应用分期CHC肝纤维化程度的诊断能效。结果fECVs和APRI指数均与CHC肝纤维化分期显著相关(r=0.842、0.813);诊断肝纤维化Metavir≥F2的ROC AUC从小到大分别为APRI(0.833)、fECVs(0.871)、两者联合(0.899);诊断肝纤维化Metavir=F4的ROC AUC从小到大分别为APRI(0.966)、fECV(0.988)、两者联合(0.998)。结论慢性丙型肝炎进展过程中肝脏纤维化程度存在区域性差异,而且肝左内叶及右后叶纤维化进展要早于其他区域。fECVs可以作为一种有效诊断慢性丙型肝炎肝纤维化程度的无创性检查方法,联合APRI指数其精准程度会更高。Objective To evaluate the diagnosis value of hepatic extracellular volume fractions(fECVs)combined with AST/PLT ratio index(APRI)in non-invasive evaluation of liver fibrosis in patients with chronic hepatitis C.Methods 120 patients with chronic hepatitis C were retrospectively analyzed.All patients underwent enhanced liver CT,and the aspartate aminotransferase and platelet counts were collected to obtain fECVs and APRI.All patients underwent liver biopsy.To compare the diagnostic effects of two methods and their combination in staging the degree of hepatic fibrosis in patients with hepatitis C.Results The values of fECVs and APRI were correlated with the stages of liver fibrosis in chronic hepatitis C,and the correlation coefficients were 0.842 and 0.813,respectively(P<0.05).The area under ROC curve(AUC)of liver METAVIR≥F2 from small to large were APRI(0.833),fECVs(0.871)and their combination(0.899).The area under ROC curve(AUC)of METAVIR=F4 was APRI(0.966),fECVs(0.988)and their combination(0.998).Conclusion There are regional differences in the degree of liver fibrosis during the progression of chronic hepatitis C,and the progression of fibrosis in the left inner lobe and the right posterior lobe of the liver is earlier than that in other regions.fECVs can be used as a noninvasive method to effectively diagnose the degree of liver fibrosis in chronic hepatitis C.It combined with APRI index,its accuracy will be higher.

关 键 词：慢性丙型肝炎 肝细胞外基质 肝纤维化 肝硬化 体层摄影术 X线计算机 

分 类 号：R657.31[医药卫生—外科学]