【摘要】 目的探讨肝纤维化指数模型(FIB-4指数)、谷草转氨酶(AST)/血小板计数(Plt)比值指数(APRI)评分、瞬时弹性成像在乙型肝炎(乙肝)后肝硬化中的诊断效能。方法选取2016年1月至2017年1月在该院住院的慢性乙肝(慢性乙肝组82例)及肝硬化(肝硬化组40例)患者采用瞬时弹性成像检测其肝脏硬度(LSM)值,同时检测谷丙转氨酶(ALT)、AST、Plt,计算出Fi B-4指数及APRI评分,分别分析LSM值、FIB-4指数及APRI在慢性乙肝后肝硬化中的诊断效能。结果两组患者性别及ALT水平比较,差异均无统计学意义(P>0.05);肝硬化组AST、Plt与慢性乙肝组比较,差异均有统计学意义(P<0.001)。慢性乙肝组患者的中位数E值、FIB-4指数、APRI评分[分别为(5.97±2.53)、(1.82±1.43)、(0.45±0.29)分]明显低于肝硬化组[分别为(13.97±10.08)、(4.29±2.82)、(0.93±0.63)分],差异均有统计学意义(P<0.05)。在慢性乙肝组患者中,肝脏E值与FIB-4指数及APRI评分均无明显相关性[相关系数(r)=0.158、0.104,P>0.05];而FIB-4与APRI评分则具有显著相关性(r=0.834,P<0.001)。在肝硬化组中,肝脏E值与FIB-4指数无明显相关性(r=0.308,P=0.053),而与APRI评分显著相关(r=0.412,P=0.008),且FIB-4指数与APRI评分也存在显著相关性(r=0.786,P<0.001)。结论在肝纤维化无创诊断模型中,瞬时弹性成像在诊断乙肝后肝硬化中的诊断效能最高,FIB-4指数次之,APRI评分最低。更多还原

【Abstract】 Objective To investigate the diagnostic efficiency of fibrosis index model(FIB-4 index),AST/Plt ratio in-dex(APRI)score and transient elastography in hepatitis B-caused cirrhosis. Methods Eighty-two inpatients with chronichepatitis B(CHB group)and 40 inpatients with liver cirrhosis(liver cirrhosis group)in this hospital from January 2016 to Janu-ary 2017 were selected. The liver stiffness measurement(LSM)value was measured by adopting the transient elastography,meanwhile the levels of ALT,AST and Plt were detected,and the Fib-4 index and APRI score were calculated. Then the diag-nostic efficiency of LSM value,Fib-4 index and APRI in hepatitis B caused cirrhosis were analyzed respectively. Results Thesex and ALT level had no statistical differences between the two groups(P>0.05); AST and Plt had statistical difference be-tween the liver cirrhosis group and the hepatitis B group(P<0.001). The median E value,FIB-4 index and APRI score were5.97±2.53,1.82±1.43 and(0.45±0.29)scores in the CHB group,which were significantly lower than 13.97±10.08,4.29±2.82 and(0.93±0.63)scores in the liver cirrhosis group,the differences were statistically significant(P<0.05). In the CHB group,the liver E value had no obvious correlation with Fib-4 index and APRI score(r=0.158,0.104,P>0.05);while FIB-4 index hadsignificant correlation with APRI score(r=0.834,P<0.001). In the liver cirrhosis group,the liver E value had no obvious corre-lation with FIB-4 index(r=0.308,P=0.053),while had significant correlation with APRI score(r=0.412,P=0.008),moreoverthe significant correlation was also existed between FIB-4 index and APRI score(r=0.786,P<0.001). Conclusion In thehepatic fibrotic non-invasive diagnosis model,the transient elastography has the highest diagnostic efficiency in diagnosinghepatitis B-caused cirrhosis,followed by Fib-4 index,and the APRI score is lowest.更多还原