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[肝脏硬度测量在慢性病毒性肝炎患者肝纤维化诊断中的应用]

[Liver stiffness measurement for the diagnosis of hepatic fibrosis in patients with chronic viral hepatitis].

作者信息

Kang Joon Koo, Cheong Jae Youn, Cho Sung Won, Cho Jin Hui, Park Jin Sun, Kim Yeong Bae, Kim Dong Joon, Hwang Seong Gyu, Yang Jin Mo, Park Young Nyun

机构信息

Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.

出版信息

Korean J Hepatol. 2007 Dec;13(4):521-9. doi: 10.3350/kjhep.2007.13.4.521.

Abstract

BACKGROUND AND AIMS

FibroScan is a new medical device that noninvasively measures liver stiffness. The aim of this study was to assess the accuracy of the liver stiffness measurement by FibroScan for making the diagnosis of liver fibrosis in patients with chronic viral hepatitis.

METHODS

We studied 103 patients with chronic viral hepatitis B or C and they underwent FibroScan and liver biopsy between October 2005 and August 2006. Liver fibrosis was staged on a 0-4 scale according to the Korean Society of Pathologists Scoring System. The diagnostic accuracy was assessed by analysis of the receiver operator characteristics (ROC).

RESULTS

The liver stiffness was 3.5-57.1 kPa (mean: 11.8, SD: 8.9). The mean value of liver stiffness in each fibrosis stage group (F1, F2, F3 and F4) was 5.8+/-1.8 kPa, 11.3+/-6.8 kPa, 11.8+/-6.0 kPa and 23.4+/-16.5 kPa, respectively. Liver stiffness measured by FibroScan showed reliable correlation with the liver fibrosis stage as confirmed by liver biopsy (r=0.56, p<0.001). The AUROC (95% CI) of > or = F2, > or = F3 and F4 was 0.93 (0.86-0.99), 0.72 (0.62-0.82) and 0.80 (0.67-0.92), respectively. The sensitivity and specificity of 7.5 kPa, which was the cutoff value for > or = F2, was 84% and 90%, respectively.

CONCLUSIONS

FibroScan is a reliable method for the diagnosis of significant fibrosis (> or =F2) and cirrhosis in patients with chronic liver disease. The liver stiffness measurement by FibroScan showed good diagnostic performance for significant fibrosis.

摘要

背景与目的

FibroScan是一种用于无创测量肝脏硬度的新型医疗设备。本研究旨在评估FibroScan测量肝脏硬度对慢性病毒性肝炎患者肝纤维化诊断的准确性。

方法

我们研究了103例慢性乙型或丙型病毒性肝炎患者,他们在2005年10月至2006年8月期间接受了FibroScan检查和肝活检。根据韩国病理学家协会评分系统,肝纤维化分为0-4级。通过分析受试者工作特征曲线(ROC)评估诊断准确性。

结果

肝脏硬度为3.5-57.1 kPa(平均值:11.8,标准差:8.9)。各纤维化阶段组(F1、F2、F3和F4)的肝脏硬度平均值分别为5.8±1.8 kPa、11.3±6.8 kPa、11.8±6.0 kPa和23.4±16.5 kPa。经肝活检证实,FibroScan测量的肝脏硬度与肝纤维化阶段具有可靠的相关性(r=0.56,p<0.001)。≥F2、≥F3和F4的曲线下面积(AUROC,95%可信区间)分别为0.93(0.86-0.99)、0.72(0.62-0.82)和0.80(0.67-0.92)。≥F2的临界值7.5 kPa的敏感性和特异性分别为84%和90%。

结论

FibroScan是诊断慢性肝病患者显著纤维化(≥F2)和肝硬化的可靠方法。FibroScan测量肝脏硬度对显著纤维化具有良好的诊断性能。

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