各种无创指标在慢性肝纤维化诊断中的诊断价值。
Diagnostic value of various noninvasive indexes in the diagnosis of chronic hepatic fibrosis.
机构信息
Department of Hepatology, Taizhou People's Hospital, Taizhou, Jiangsu, China.
出版信息
Eur Rev Med Pharmacol Sci. 2018 Jan;22(2):479-485. doi: 10.26355/eurrev_201801_14198.
OBJECTIVE
Hepatic fibrosis is a repair response to chronic liver injury. This study evaluated the diagnostic value of various noninvasive indicators for hepatic fibrosis in patients with chronic liver disease.
PATIENTS AND METHODS
95 patients with liver biopsy were enrolled in this study. Routine clinical and laboratory examinations were collected, including age, sex, blood routine, biochemistry, serum fibrosis, and FibroTouch. APRI and FIB4 scores were calculated. The patients were grouped according to liver pathological staging to analyze the correlation between the fibrosis with serum fibrosis, APRI, FIB4 score, and FibroTouch. The receiver operator characteristics of S2, S3, and S4 were analyzed to calculate the area under the curve (AUC).
RESULTS
No statistical difference was found on age, ALT, AST, GGT, BMI, TG, CHOL, and Glu (p > 0.05). Liver stiffness measurement (LSM), APRI, FIB4, PCIII, CIV, LN, and HA exhibited statistical significance (p < 0.05). Further correlation analysis showed that PCIII, IV-C, LN, APRI, LSM, and FIB4 were positively correlated with the stage of hepatic fibrosis (p < 0.05). ROC curve analysis demonstrated that LSM and FIB4 revealed good predictions of various stages of fibrosis in chronic liver disease with AUC greater than 0.7. The AUC of LSM in the diagnosis of liver cirrhosis (S4) reached 0.908. Its accuracy was influenced by liver inflammation.
CONCLUSIONS
The LSM value in FibroTouch showed high coincidence rate with hepatic fibrosis staging. It is a valuable noninvasive method for assessing the progression of hepatic fibrosis in chronic liver disease.
目的
肝纤维化是慢性肝损伤的修复反应。本研究评估了各种非侵入性指标对慢性肝病患者肝纤维化的诊断价值。
方法
本研究纳入了 95 例肝活检患者。收集了常规临床和实验室检查，包括年龄、性别、血常规、生化、血清纤维化和 FibroTouch。计算了 APRI 和 FIB4 评分。根据肝病理分期将患者分组，分析纤维化与血清纤维化、APRI、FIB4 评分和 FibroTouch 的相关性。分析 S2、S3 和 S4 的受试者工作特征曲线，计算曲线下面积（AUC）。
结果
年龄、ALT、AST、GGT、BMI、TG、CHOL 和 Glu 无统计学差异（p > 0.05）。肝硬度测量（LSM）、APRI、FIB4、PCIII、CIV、LN 和 HA 有统计学意义（p < 0.05）。进一步的相关分析表明，PCIII、IV-C、LN、APRI、LSM 和 FIB4 与肝纤维化分期呈正相关（p < 0.05）。ROC 曲线分析表明，LSM 和 FIB4 对慢性肝病各期纤维化具有良好的预测作用，AUC 均大于 0.7。LSM 诊断肝硬化（S4）的 AUC 达到 0.908。其准确性受肝脏炎症的影响。
结论
FibroTouch 中的 LSM 值与肝纤维化分期具有高度一致性。它是评估慢性肝病肝纤维化进展的一种有价值的非侵入性方法。
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