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瞬时弹性成像(FibroScan)在评估自身免疫性肝炎患者的肝纤维化和肝硬化方面优于非侵入性标志物。

Transient Elastography (FibroScan) Performs Better Than Non-Invasive Markers in Assessing Liver Fibrosis and Cirrhosis in Autoimmune Hepatitis Patients.

机构信息

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).

Shengzhou People's Hospital, Shengzhou Branch of The First Affiliated Hospital of Zhejiang University, Shengzhou, Zhejiang, China (mainland).

出版信息

Med Sci Monit. 2017 Oct 26;23:5106-5112. doi: 10.12659/msm.907300.

Abstract

BACKGROUND Autoimmune hepatitis (AIH) is an immune-mediated chronic liver disease that can lead to severe fibrosis and cirrhosis. Transient elastography (TE, FibroScan) can assess the fibrotic stages of chronic liver diseases by liver stiffness measurement (LSM). Studies on the diagnostic accuracy of FibroScan for the detection of fibrosis in AIH patients are still limited. MATERIAL AND METHODS This study enrolled 108 AIH patients who underwent liver biopsies. Using the METAVIR scoring system as the reference, Spearman's rank correlation was performed to explore the relationship between the markers and stages of fibrosis. The area under the receiver operating characteristic curve (AUROC) was used to evaluate the diagnostic accuracy. The optimal LSM cut-off values for predicting the stages of fibrosis were calculated. RESULTS LSM was superior to other non-invasive markers in differentiating the stages of fibrosis in AIH patients. AUROC value of LSM was 0.885 for stage F2, 0.897 for stage F3, and 0.878 for stage F4. The optimal LSM cut-off value was 6.27 kPa for stage F2, 8.18 kPa for F3, and 12.67 kPa for F4. CONCLUSIONS FibroScan is a valuable non-invasive method for the evaluation of liver fibrosis of AIH patients.

摘要

背景

自身免疫性肝炎(AIH)是一种免疫介导的慢性肝脏疾病,可导致严重的纤维化和肝硬化。瞬时弹性成像(TE,FibroScan)可通过肝硬度测量(LSM)评估慢性肝病的纤维化阶段。关于 FibroScan 检测 AIH 患者纤维化的诊断准确性的研究仍然有限。

材料与方法

本研究纳入了 108 例接受肝活检的 AIH 患者。采用 METAVIR 评分系统作为参考,进行 Spearman 秩相关分析,以探讨标志物与纤维化分期之间的关系。采用受试者工作特征曲线(AUROC)下面积评估诊断准确性。计算预测纤维化分期的最佳 LSM 截断值。

结果

LSM 在区分 AIH 患者纤维化分期方面优于其他非侵入性标志物。LSM 的 AUROC 值分别为 F2 期 0.885、F3 期 0.897 和 F4 期 0.878。最佳 LSM 截断值分别为 F2 期 6.27 kPa、F3 期 8.18 kPa 和 F4 期 12.67 kPa。

结论

FibroScan 是评估 AIH 患者肝纤维化的一种有价值的非侵入性方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bce/5669534/cad81158526f/medscimonit-23-5106-g001.jpg

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