Fibroscan对HBV感染者肝纤维化诊断的临床研究(1)
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[摘要] 目的：探讨FibroScan在HBV感染者肝纤维化诊断中的临床应用价值。方法：随即抽取FibroScan检测的HBV感染者300例，包括急性乙型肝炎患者22例，慢性乙型肝炎161例，乙肝肝硬化117例，分析FibroScan检测值(FS值)与肝功能、HBV载量、血清纤维化指标及超声诊断结果的相关性。结果：FS值与血清学检验指标进行多重线性回归分析，FS值与ALB、TBIL、HA、ALT和LN之间具有显著相关性(P<0.05)。肝硬化组FS值显著高于CHB组和AHB组(P<0.05)，但CHB组和AHB组之间比较差异无统计学意义(P>0.05)。FS值与HBV载量高低无明显相关性(r=0.081，P=0.697)。FS值与超声诊断分组之间具有显著相关性(r=0.685，P=0.000)。结论：FibroScan对诊断HBV感染相关的肝纤维化具有较高的临床价值。
[关键词] 肝弹性成像系统；肝纤维化；慢性乙型肝炎；乙肝病毒
[中图分类号] R575.2[文献标识码]A [文章编号]1673-7210(2011)04(b)-042-03
Clinical study of FibroScan on the diagnosis of liver fibrosis in patients with hepatitis B virus
LIU Yongpeng, ZHANG Lin
Qingdao Hospital for Infectious Diseases, Shandong Province, Qingdao 266033, China
[Abstract] Objective: To explore the clinical application value of FibroScan in the diagnosis of liver fibrosis in patients with hepatitis B virus. Methods: Enrolling randomly 300 patients with hepatitis B virus were detected with FibroScan, including 22 cases of acute hepatitis (AHB), 161 cases of chronic hepatitis (CHB) and 171 cases of liver cirrhosis (LC). To analyze the correlations of FibroScan values (FS) and the serum indexes of liver function, HBV DNA loads, serum fibrosis markers and ultrasound diagnosis. Results: FS values were markedly correlated with serum ALB, TBIL, HA, ALT and LN according to multiple linear regression analysis (P<0.05). The FS value of LC group was significantly higher than that of CHB group and AHB group (P<0.05), but the different of CHB group and AHB group was no statistical significance (P>0.05). The FS value was not related to the HBV DNA loads (r=0.081, P=0.697), but correlated with the ultrasonic diagnostic significantly(r=0.685, P=0.000). Conclusion: FibroScan has a better clinical application value in the diagnosis of liver fibrosis in patients with hepatitis B virus.
[Key words] FibroScan; Liver fibrosis; Chronic hepatitis; Hepatitis B virus
肝脏纤维化是所有慢性肝脏疾病进展的结果[1]，及时诊断肝纤维化并准确判断其程度和进展情况，以指导临床给予有效的干预，延缓或阻止疾病进展为肝硬化、失代偿期肝硬化。目前经皮肝脏穿刺活检组织检查(肝活检)仍是诊断肝脏纤维化和评价抗纤维化疗效的“金标准”[2]，但因为其有创、潜在风险、采样局限性和可重复性差等因素而限制了其在临床的广泛应用 ......
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