Kim Do Young, Kim Seung Up, Ahn Sang Hoon, Park Jun Yong, Lee Jung Min, Park Young Nyun, Yoon Ki Tae, Paik Yong Han, Lee Kwan Sik, Chon Chae Yoon, Han Kwang-Hyub
Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, South Korea.
Dig Dis Sci. 2009 Aug;54(8):1758-63. doi: 10.1007/s10620-008-0541-2. Epub 2008 Nov 13.
It is difficult to differentiate early compensated cirrhosis from chronic hepatitis solely by clinical features. The aim of this study was to assess the usefulness of liver stiffness measurement (LSM) for detection of early compensated liver cirrhosis in chronic hepatitis B (CHB).
Ninety-one consecutive CHB patients who underwent liver biopsy (LB) and LSM were recruited. All patients did not fulfill the clinical criteria for cirrhosis. The cutoff of LSM for cirrhosis was 10.3 kPa.
All patients were divided into either group A (cirrhosis) or group B (CHB) according to LB result. The median LSM values of groups A and B were 11.8 and 7.6 kPa, respectively (P < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of LSM in predicting cirrhosis were 0.59, 0.78, 0.68, and 0.72, respectively. The area under the receiver operating characteristics curve (AUROC) of LSM was 0.803, whereas the AUROCs of aspartate to alanine aminotransferase ratio (AAR) and aspartate aminotransferase to platelet ratio index (APRI) were 0.488 and 0.723, respectively.
LSM showed an acceptable diagnostic accuracy for detecting early compensated cirrhosis in CHB.
仅通过临床特征很难将早期代偿期肝硬化与慢性肝炎区分开来。本研究的目的是评估肝脏硬度测量（LSM）在检测慢性乙型肝炎（CHB）早期代偿期肝硬化中的作用。
招募了91例连续接受肝活检（LB）和LSM检查的CHB患者。所有患者均不符合肝硬化的临床标准。肝硬化的LSM临界值为10.3 kPa。
根据LB结果将所有患者分为A组（肝硬化）或B组（CHB）。A组和B组的LSM中位数分别为11.8 kPa和7.6 kPa（P < 0.001）。LSM预测肝硬化的敏感性、特异性、阳性预测值和阴性预测值分别为0.59、0.78、0.68和0.72。LSM的受试者工作特征曲线下面积（AUROC）为0.803，而天冬氨酸与丙氨酸转氨酶比值（AAR）和天冬氨酸转氨酶与血小板比值指数（APRI）的AUROC分别为0.488和0.723。
LSM在检测CHB早期代偿期肝硬化方面显示出可接受的诊断准确性。
