Fibrotouch联合血清标志物评估慢性乙型肝炎肝纤维化的价值  

Value of Fibrotouch Combined With Serum Markers in Evaluating Hepatic Fibrosis in Patients With Chronic Hepatitis B

作　　者：杨兆辉[1] 陈珑斌[1] 马龙[1] YANG Zhaohui;CHEN Longbin;MA Long(Department ofInfectious Diseases,the Third Hospital of Xiamen,Xiamen Fujian 361100,China)

机构地区：[1]厦门市第三医院感染科,福建厦门361100

出　　处：《中国卫生标准管理》2024年第14期14-18,共5页China Health Standard Management

摘　　要：目的分析瞬时弹性成像技术(Fibrotouch)评估联合血清标志物在慢性乙型肝炎肝纤维化程度评估中的价值。方法选择厦门市第三医院2019年3月—2021年9月收治的180例慢性乙型肝炎患者作为研究对象。依病理结果分为无纤维化组72例、早期纤维化组68例和进展性纤维化组40例。所有患者均接受Fibrotouch检测肝脏硬度值(liver stiffness measurement,LSM)、血清透明质酸(hyaluronic acid,HA)、黏连蛋白(laminin,LN)、Ⅳ型胶原(collage typeⅣ,CⅣ)和Ⅲ型前胶原(precollagen typeⅢ,PCⅢ)水平。Spearman相关性分析LSM、HA、LN、CⅣ、PCⅢ水平与肝纤维化程度的相关性。受试者工作特征(receiver operating characteristic,ROC)曲线分析上述指标联合检测诊断肝纤维化的价值。结果不同肝纤维程度患者LSM、HA、LN、CⅣ、PCⅢ比较,差异有统计学意义(P<0.05);且进展性纤维化组各指标均高于早期纤维化组、无纤维化组,早期纤维化组各指标均高于无纤维化组(P<0.05);LSM、HA、LN、CⅣ、PCⅢ均与肝纤维化程度呈正相关,相关系数分别为0.949、0.912、0.898、0.867、0.893(P<0.05);ROC曲线分析显示,LSM、HA、LN、CⅣ、PCⅢ、联合检测肝纤维化曲线下面积(area under curve,AUC)分别为0.790、0.839、0.623、0.863、0.804、0.968,联合检测预测效果最好,且联合检测敏感度高于其他各项单独检测指标(P<0.05)。结论慢性乙型肝炎患者LSM、HA、LN、CⅣ、PCⅢ均与肝纤维化程度呈正相关,上述指标联合检查效果最好,敏感度最高,临床可联合检测上述指标诊断肝纤维化。Objective To analyze the value of transient elastography(Fibrotouch)combined with serum biomarkers in evaluating the degree of liver fibrosis in chronic hepatitis B.Methods A total of 180 patients with chronic hepatitis B admitted to the Third Hospital of Xiamen from March 2019 to September 2021 were selected as the study subjects.According to pathological results,there were 72 cases in the non fibrosis group,68 cases in the early fibrosis group,and 40 cases in the progressive fibrosis group.Liver stiffness measurement(LSM),hyaluronic acid(HA),laminin(LN),collage typeⅣ(CⅣ)and precollagen typeⅢ(PCⅢ)levels were measured by Fibrotouch in all patients.Spearman correlation analysis of the correlation between LSM,serum HA,LN,CⅣ,PCⅢlevels,and the degree of liver fibrosis.Receiver operating characteristic(ROC)curve was used to analyze the value of the combined detection of the above indicators in the diagnosis of liver fibrosis.Results There were statistically significant differences in LSM,HA,LN,CⅣand PCⅢamong patients with different degrees of liver fibrosis(P<0.05),and all indicators in the progressive fibrosis group were higher than those in the early fibrosis group and the non fibrosis group.All indicators in the early fibrosis group were higher than those in the non fibrosis group(P<0.05).LSM,HA,LN,CⅣand PCⅢwere all positively correlated with the degree of liver fibrosis,with correlation coefficients of 0.949,0.912,0.898,0.867 and 0.893,respectively(P<0.05).ROC curve analysis showed that LSM,HA,LN,CⅣ,PCⅢ,and combined detection of liver fibrosis area under curve(AUC)were 0.790,0.839,0.623,0.863,0.804 and 0.968,respectively.The combined detection had the best predictive effect,and the sensitivity of the combined detection was higher than other individual detection indicators(P<0.05).Conclusion LSM,HA,LN,CⅣand PCⅢin patients with chronic hepatitis B are positively correlated with the degree of liver fibrosis.The combination of the above indicators has the best detection effect and sensitivi

关 键 词：瞬时弹性成像技术评估 血清标志物 慢性乙型肝炎 肝纤维化程度 肝脏硬度值 价值评估 

分 类 号：R445[医药卫生—影像医学与核医学]