通过测量非酒精性脂肪性肝病（NAFLD）患者的肝脏硬度进行肝纤维化的无创评估。
Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with nonalcoholic fatty liver disease (NAFLD).
作者信息
Yoneda M, Yoneda M, Mawatari H, Fujita K, Endo H, Iida H, Nozaki Y, Yonemitsu K, Higurashi T, Takahashi H, Kobayashi N, Kirikoshi H, Abe Y, Inamori M, Kubota K, Saito S, Tamano M, Hiraishi H, Maeyama S, Yamaguchi N, Togo S, Nakajima A
机构信息
Division of Gastroenterology, Yokohama City University, Graduate School of Medicine, 3-9 Fuku-ura, Yokohama, Japan.
出版信息
Dig Liver Dis. 2008 May;40(5):371-8. doi: 10.1016/j.dld.2007.10.019. Epub 2007 Dec 20.
BACKGROUND
Liver fibrosis is the main predictor of the progression of nonalcoholic fatty liver disease. Transient elastography (FibroScan), which measures liver stiffness, is a novel, noninvasive method to assess liver fibrosis.
AIM
We investigated the usefulness of liver stiffness measurement in the evaluation of liver fibrosis in nonalcoholic fatty liver disease patients.
STUDY POPULATION
A total of 97 nonalcoholic fatty liver disease patients.
METHODS
Transient elastography was performed for liver stiffness measurement in 97 nonalcoholic fatty liver disease patients. And the relationship between histological parameters and liver stiffness measurement was studied by multivariate analysis. Moreover, we investigated the relationship between liver stiffness measurement and the serum levels of hyaluronic acid and type IV collagen 7s domain.
RESULTS
The liver stiffness was well correlated with the stage of liver fibrosis (Kruskal-Wallis test p < 0.0001). The areas under the receiver-operating characteristic curves were 0.927 for > or = F1, 0.865 for > or = F2, 0.904 for > or = F3, 0.991 for > or = F4. Only fibrosis stage was correlated significantly with liver stiffness measurement by multiple regression analysis. Liver stiffness was also strongly correlated with the serum levels of type IV collagen 7s domain (r = 0.525, p < 0.0001) and hyaluronic acid (r = 0.457, p < 0.0001).
CONCLUSIONS
Our results show a significant correlation between liver stiffness measurement and fibrosis stage in nonalcoholic fatty liver disease patients, as confirmed by the results of liver biopsy, which remains the gold standard for evaluation of the severity of liver fibrosis in patients with nonalcoholic steatohepatitis.
背景
肝纤维化是非酒精性脂肪性肝病进展的主要预测指标。瞬时弹性成像（FibroScan）可测量肝脏硬度，是一种评估肝纤维化的新型非侵入性方法。
目的
我们研究了肝脏硬度测量在评估非酒精性脂肪性肝病患者肝纤维化中的作用。
研究对象
总共97例非酒精性脂肪性肝病患者。
方法
对97例非酒精性脂肪性肝病患者进行瞬时弹性成像以测量肝脏硬度。通过多变量分析研究组织学参数与肝脏硬度测量之间的关系。此外，我们研究了肝脏硬度测量与透明质酸和IV型胶原7s结构域血清水平之间的关系。
结果
肝脏硬度与肝纤维化分期密切相关（Kruskal-Wallis检验p<0.0001）。受试者操作特征曲线下面积对于≥F1为0.927，对于≥F2为0.865，对于≥F3为0.904，对于≥F4为0.991。通过多元回归分析，仅纤维化分期与肝脏硬度测量显著相关。肝脏硬度也与IV型胶原7s结构域血清水平（r = 0.525，p<0.0001）和透明质酸（r = 0.457，p<0.0001）密切相关。
结论
我们的结果显示非酒精性脂肪性肝病患者的肝脏硬度测量与纤维化分期之间存在显著相关性，肝活检结果证实了这一点，肝活检仍是评估非酒精性脂肪性肝炎患者肝纤维化严重程度的金标准。
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