【摘要】 目的分析瞬时弹性成像技术(FibroScan)结合血清学标志物检测在肝纤维化诊断中的应用。方法选取乙型肝炎患者163例,进行肝脏活检、常规生化学检测、FibroScan检测。根据肝脏活检结果将患者分为轻、中、重度肝纤维化及肝硬化4组。确定FibroScan、APRI、FIB-4、FibroScan联合APRI及FibroScan联合FIB-4诊断不同程度肝纤维化的临界值、敏感度、特异度、阳性预测值及阴性预测值。结果 FibroScan、APRI及FIB-4单独诊断重度肝纤维化及肝硬化的敏感度及特异度较好,单独诊断轻、中度肝纤维化的敏感度欠佳,分别为54.33%、61.70%、57.52%和60.74%、59.49%、63.31%。而FibroScan联合APRI或FIB-4诊断轻、中度肝纤维化的敏感度为63.94%、65.78%和64.56%、66.58%,明显优于FibroScan单独诊断时的敏感性。结论 FibroScan联合APRI或FIB-4可显著提高对轻、中度肝纤维化的诊断敏感性,对尽早发现肝纤维化并准确判定纤维化程度具有重要作用。更多还原

【Abstract】 Objective To determine the usefulness of transient elastography(FibroScan) combined with other serologic markers in diagnosing liver fibrosis.Methods 163 patients with hepatitis B virus(HBV) infection were enrolled and detected for liver biopsy,routine biochemical examination and FibroScan.Patients were divided into four groups according to liver biopsy.Sensitivity,specificity,positive predictive value and negative predictive value of FibroScan,APRI,FIB-4 and FibroSan combined with APRI or FIB-4 were applied for diagnosing different stages of liver fibrosis.Results Sensitivity and specificity of FibroScan,APRI and FIB-4 for diagnosing severe liver fibrosis and cirrhosis of liver were satisfying.But the sensitivity of FibroScan,APRI and FIB-4 for diagnosing mild liver and moderate liver fibrosis was only 54.33%,61.70%,57.52% and 60.74%,59.49%,63.31%,respectively.The sensitivity of FibroSan combined with APRI or FIB-4 for diagnosing mild liver and moderate liver fibrosis were 63.94%,65.78% and 64.56%,66.58%,which were obviously higher than that obtained using FibroScan alone.Conclusion The combination of FibroScan with APRI or FIB-4 could significantly improve the sensitivity of diagnosing mild liver and moderate liver fibrosis,which could be used for diagnosing liver fibrosis early and exactly.更多还原