Abstract:Objective: To observe the correlation between liver stiffness measured by transient elastography (Fibroscan) and liver biopsy pathological stage of patients with chronic hepatitis B. Methods: 196 cases of patients with chronic hepatitis B who were admitted to the hospital from January 2016 to January 2018 were selected as the subjects. All patients underwent liver biopsy to determine the stage of liver fibrosis, and Fibroscan was used for liver stiffness measurement (LSM). The correlation of LSM with liver fibrosis was analyzed. Results: The sensitivity, specificity, accuracy and Kappa value of Fibroscan in detecting LSM stage S0 were 92.31% (12/13), 100.00% (183/183), 99.49% (195/196) and 0.96, respectively. For S1, the sensitivity, specificity, accuracy and Kappa value were 100.00%(54/54), 97.18%(138/142), 97.96%(192/196)and 0.95, respectively. Those for S2 were 97.18%(69/71), 99.20%(124/125), 98.47%(193/196)and 0.97, respectively, for S3 were 93.33% (42/45), 100.00% (151/151), 98.47% (193/196) and 0.96, respectively, and for S4 were 92.31%(12/13), 98.91%(181/183), 98.48%(193/196)and 0.88, respectively. Levels of ALT, AST, Knodell score and LSM were significantly lower in the mild fibrosis group than in the moderate and severe fibrosis group (P < 0.05). The LSM measured by Fibroscan was an independent risk factor for liver biopsy pathological stage (P < 0.05), and it was positively correlated with Knodell score and liver biopsy pathological stage (P < 0.05). Conclusion: Fibroscan can be used as a reference for evaluating the stage of liver fibrosis. Instead of partial liver biopsy, it is of great value for early diagnosis of liver cirrhosis.
曹发明, 张照如, 王翔. Fibroscan测定慢性乙型肝炎患者肝硬度值与肝组织活检病理学分期的相关性研究[J]. 河北医学, 2018, 24(7): 1223-1225.
CAO Faming, ZHANG Zhaoru, WANG Xiang. The Study Correlation between Liver Stiffness and Pathological Staging of Liver Biopsy in Patients with Chronic Hepatitis B by Fibroscan. HeBei Med, 2018, 24(7): 1223-1225.
[1] 张鹏,张长江,朱研,等.阿德福韦酯长期应用对慢性乙型肝炎患者肾功能的影响[J].医学临床研究,2017,34(10):1873~1876. [2] 魏越.苦参素胶囊联合重组人干扰素对高AFP(甲胎蛋白)慢性乙肝患者纤维化指标及炎症因子的影响[J].湖南师范大学学报(医学版),2017,14(1):104~107. [3] 张胜林,王焕侠,刘翠玲,等.超声二维量化指标及肝静脉波形分型在慢性乙型肝炎肝纤维化程度评估中的应用[J].蚌埠医学院学报,2016,41(6):791~792. [4] 王建芳.慢性乙型肝炎患者肝纤维化诊断中瞬时弹性波扫描仪的应用[J].中国基层医药,2017,24(8):1254~1256. [5] 中华医学会肝病学分会中华医学会感染病学分会.慢性乙型肝炎防治指南2010年更新版[J].中华实验和临床感染病杂志:电子版,2011,5(1):50~60. [6] Bedossa P, Poynard T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group.[J]. Hepatology,1996,24(2):289~293. [7] 中华医学会传染病与寄生虫病学分会、肝病学分会.病毒性肝炎防治指南[J].肝脏,2000,5(4):257~263. [8] 方正亚,张国顺,刘斌,等.肝脏硬度指标对ALT正常慢性乙型肝炎患者肝纤维化的诊断价值[J].山东医药,2017,57(21):55~57. [9] 娄海山,许秋玉.肝脏瞬时弹性探测仪在诊断慢性乙型肝炎患者不同分期肝纤维化中的应用价值[J].广西医学,2017,39(9):1364~1366. [10] 魏华,王海梅,郭何.FibroScan用于慢性肝病患者肝纤维化的早期诊断价值[J].现代消化及介入诊疗,2017,22(3):315~318. [11] 李振挺,李芹,林恢,等.FibroScan与慢性乙型肝炎肝组织炎症及纤维化程度的相关性研究[J].中西医结合肝病杂志,2016,26(5):270~271.