酒精性肝病和非酒精性脂肪性肝病的瞬时弹性成像：系统评价和荟萃分析。
Transient Elastography in Alcoholic Liver Disease and Nonalcoholic Fatty Liver Disease: A Systemic Review and Meta-Analysis.
机构信息
Department of Gastroenterology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China.
Department of Gastroenterology, Sanmen People's Hospital, Taizhou, China.
出版信息
Can J Gastroenterol Hepatol. 2021 Jan 20;2021:8859338. doi: 10.1155/2021/8859338. eCollection 2021.
BACKGROUND AND AIMS
Alcoholic liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD) have become common chronic liver diseases. Recent evidence has shown the value of transient elastography (TE) in the context of ALD/NAFLD. The aim of this study is to investigate the accuracy of TE for diagnosing steatosis and fibrosis in ALD/NAFLD patients.
METHODS
We retrieved relevant English studies from the databases of PubMed, Embase, the Web of Science, and the Cochrane Library through March 31 2019. We included studies regarding the diagnosis or staging of steatosis or fibrosis by using controlled attenuation parameter (CAP) or liver stiffness measurement (LSM) measured by TE in patients with ALD or NAFLD. The reference standard of all included studies was liver biopsy. A random-effects model was applied. Statistical analyses were performed using STATA.
RESULTS
A total of 62 articles were included and analyzed in our meta-analysis. In patients with ALD/NAFLD, the pooled results revealed that the sensitivity and specificity of CAP were 0.84, 0.83, and 0.78 and 0.83, 0.71, and 0.62 for steatosis grades 1, S2, and =3, respectively. The sensitivity and specificity of LSM for identifying fibrosis grades 1, F2, F3, and =4 were 0.77, 0.77, 0.83, and 0.91 and 0.80, 0.82, 0.84, and 0.86, respectively.
CONCLUSION
In patients with ALD/NAFLD, CAP was feasible for identifying and screening steatosis, and LSM was accurate for diagnosing fibrosis, especially severe fibrosis and cirrhosis.
背景与目的
酒精性肝病（ALD）和非酒精性脂肪性肝病（NAFLD）已成为常见的慢性肝病。最近的证据表明，瞬时弹性成像（TE）在 ALD/NAFLD 中的价值。本研究旨在探讨 TE 诊断 ALD/NAFLD 患者脂肪变性和纤维化的准确性。
方法
我们通过检索 PubMed、Embase、Web of Science 和 Cochrane Library 数据库，检索了截至 2019 年 3 月 31 日的相关英文研究。我们纳入了关于使用受控衰减参数（CAP）或 TE 测量的肝硬度测量（LSM）诊断 ALD 或 NAFLD 患者脂肪变性或纤维化的研究。所有纳入研究的参考标准均为肝活检。采用随机效应模型。使用 STATA 进行统计分析。
结果
共有 62 篇文章被纳入并进行了荟萃分析。在 ALD/NAFLD 患者中，汇总结果显示，CAP 对脂肪变性 1 级、S2 级和=3 级的敏感度和特异度分别为 0.84、0.83、0.78 和 0.83、0.71、0.62。LSM 对纤维化 1 级、F2 级、F3 级和=4 级的诊断敏感度和特异度分别为 0.77、0.77、0.83 和 0.91、0.80、0.82、0.84 和 0.86。
结论
在 ALD/NAFLD 患者中，CAP 可用于识别和筛查脂肪变性，LSM 可用于准确诊断纤维化，尤其是严重纤维化和肝硬化。
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