Fibroscan无创性评估慢性乙型肝炎肝纤维化的应用价值

摘要

Objective To investigate the application value of Fibroscan for liver fibrosis in patients with chronic hepatitis B (CHB) .Methods Liver stiffness measurement (LSM)of 105 patients with CHB were measured by Fibroscan before the liv‐er biopsy .Pathological diagnosis of liver biopsy was adopted to perform the liver fibrosis stage (S) .With the liver biopsy as the gold standard for judging liver fibrosis , receiver operating characteristic (ROC) curves were drawed ,and the area under the ROC curves (AUC) was calculated .Results There was a significantly positive correlation between liver stiffness measurement and liver fibrosis stage (r=0.768 , P<0.01) .The AUC of liver biopsy fibrosis stage ≥S1、 ≥S2、 ≥S3、S4 were 0.886、0.902、0.941 and 0.957 ,respectively .The cut‐off values of LSM were 5.11、7.12、11.25 and 15.76 kPa by maximizing the sum of sensitivity and specificity . Conclusion Noninvasive assessment of liver fibrosis by using FS is an effective way ,and w hich has a good value in clinical application .%目的：探讨肝脏瞬时弹性波扫描仪（Fibroscan ， FS）对慢性乙型肝炎肝脏纤维化的应用价值。方法应用FS对105名慢性乙型肝炎患者进行肝穿刺前肝脏硬度测量值（LSM ）的测定，采用肝穿刺活组织病理诊断技术进行肝纤维化分期（S），并将肝穿刺组织学检查作为判断肝纤维化的金标准绘制FS工作特征曲线，算出ROC曲线下面积（AUC）。结果肝脏硬度值和肝组织纤维化分期呈显著正相关（ r＝0.768， P＜0.01）。肝活检纤维化分期≥S1、≥S2、≥S3、S4的AUC分别为0.886、0.902、0.941、0.957，以灵敏度和特异度之和的最大值选定的诊断界值（cut‐off 值）分别为5.11、7.12、11.25、15.76 kPa。结论 FS无创性评估肝纤维化为一种有效可行的方法，有较好的临床应用价值。