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受控衰减参数对慢性乙型肝炎患者肝脂肪变性的诊断价值

Diagnostic value of controlled attenuation parameter for liver steatosis in patients with chronic hepatitis B.

作者信息

Wang Chun-Yan, Lu Wei, Hu Dong-Sheng, Wang Guang-Dong, Cheng Xiao-Jing

机构信息

Chun-Yan Wang, Wei Lu, Dong-Sheng Hu, Tianjin Second People's Hospital, Tianjin 300192, China.

出版信息

World J Gastroenterol. 2014 Aug 14;20(30):10585-90. doi: 10.3748/wjg.v20.i30.10585.

Abstract

AIM

To study the diagnostic value of controlled attenuation parameter (CAP), evaluated by transient elastography, for liver steatosis in patients with chronic hepatitis B (CHB).

METHODS

Eighty-eight patients with CHB were enrolled in this study. All of the patients were subjected to transient elastography to determine CAP. These patients also underwent liver biopsy in the same period. Using liver biopsy as a reference, we determined receiver operating characteristic (ROC) curves for different endpoints. Areas under the ROC curves (AUCs) were used to evaluate the diagnostic importance of CAP for liver steatosis in patients with CHB.

RESULTS

A positive correlation was observed between the AUCs of CAP and liver pathological stage (r = 0.582, P < 0.05). CAP was not correlated with inflammation degree and fibrosis degree (r = -0.025, P > 0.05; r = 0. 068, P > 0.05). The mean CAP value at S0 was 209.59 ± 41.25 dB/m, 223.84 ± 35.28 dB/m at S1, 274.17 ± 43.69 dB/m at S2, and 312.50 ± 25.44 dB/m at S3. CAP values among S0, S1, S2, and S3 were significantly different (F = 17.79, P < 0.01). The AUC values for CAP were 0.711 (0.592-0.870), 0.868 (0.748-0.989), and 0.974 (0.922-1.026) for S1, S2, and S3, respectively. The optimal cut-off values were 219.5, 230.0, and 283.5 dB/m.

CONCLUSION

CAP is a novel tool that can be used to assess the degree of steatosis.

摘要

目的

研究通过瞬时弹性成像评估的受控衰减参数(CAP)对慢性乙型肝炎(CHB)患者肝脂肪变性的诊断价值。

方法

本研究纳入了88例CHB患者。所有患者均接受瞬时弹性成像以测定CAP。这些患者在同一时期还接受了肝活检。以肝活检为参照,我们确定了不同终点的受试者操作特征(ROC)曲线。ROC曲线下面积(AUC)用于评估CAP对CHB患者肝脂肪变性的诊断重要性。

结果

CAP的AUC与肝脏病理分期之间存在正相关(r = 0.582,P < 0.05)。CAP与炎症程度和纤维化程度无相关性(r = -0.025,P > 0.05;r = 0.068,P > 0.05)。S0期的平均CAP值为209.59±41.25 dB/m,S1期为223.84±35.2,8 dB/m,S2期为274.17±43.69 dB/m,S3期为312.50±25.44 dB/m。S0、S1、S2和S3期的CAP值有显著差异(F = 17.79,P < 0.01)。S1、S2和S3期CAP的AUC值分别为0.711(0.592 - 0.870)、0.868(0.748 - 0.989)和0.974(0.922 - 1.026)。最佳截断值分别为219.5、230.0和283.5 dB/m。

结论

CAP是一种可用于评估脂肪变性程度的新型工具。

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