摘要
目的探讨影响瞬时弹性记录仪FibroScan测量肝纤维化成功率因素及其重复性。方法用FibroScan对637例健康人群、慢性乙肝病毒携带者、慢性肝炎和肝硬化患者共进行939次系列肝脏硬度测量。其中302例受检者进行了2次系列检测。对同一检测对象,两位操作者分别检测或同一操作者分别进行2次系列检测,每系列检测取10个检测值,取中位数为最终检测值。分析评价体质量指数、性别、年龄、疾病状态等对检测成功率的影响,组内相关系数(ICC)评价FibroScan检测结果的可重复性。结果14例无法获得弹性值,失败率为2.2%。失败率与疾病状况无关,质量指数高将使成功率降低(t=3.112,P=0.002)。女性成功率较男性低(t=-2.193,P=0.029)。对同一检测对象,同一操作者多次操作或不同操作者进行FibroScan检测,ICC分别为0.970、0.847;对于健康和慢性乙肝病毒携带受检者,FibroScan检测稳定性下降(ICC分别为0.736、0.639)。既往肝硬化并发症病史及高肝功能Child-Pugh评分将使肝硬化患者FibroScan弹性值升高。结论FibroScan检测慢性肝病患者肝纤维化程度稳定性良好;高体质量指数降低操作成功率;高弹性值可能预测肝硬化并发症及肝功能代偿状态。
Objective To investigate the factors influencing the success rate and stability of transient elastography（FibroScan） for assessment of liver fibrosis. Methods Liver stiffuess was assessed using transient elastography in totally 637 subjects including healthy subjects, asymptomatic hepatitis B virus （HBV） carders, patients with chronic hepatitis B and patients with HBV-related cirrhosis. Of these subjects, 302 received 2 examinations totalling 939 examinations were perfromed. In each case, one operator performed 2 consecutive series of 10 validated measurements, or 2 operators performed a series of 10 validated measurements. The factors including dender, age, body mass index （BMI） and the state of diseases were analyzed for their association with the success of the examination. Intraclass correlation coefficient （ICC） was used to evaluate the reproducibility of the operation. Results Failure of the measurement occurred in 14 cases （2.2%）, which was not associated with the age of the subjects and the state of diseases. The success rate of measurement decreased as the BMI increased （t= 3.112, P=-0.002）, and was lower in female subjects （t=-2.193, P=-0.029）. The intra- and inter-operator stability of liver stiffuess measurement was satisfactory, with ICC of 0.970 and 0.847, respectively. But for healthy subjects and asymptmatic HBV carders, the stability was lower, with ICC of 0.736 and 0.639, respectively. Liver stiffuess in patients with liver cirrhosis was positively correlated to complications and Child-Turcotte-Pugh （CTP） score. Conclusions Liver stiffuess measurement has high stability with FibroScan, and high BMI could lower success rate of the measurement. Liver stiffness as measured by FibroScan allows prediction of the liver function and presence of complications in patients with liver cirrhosis.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2008年第4期595-597,共3页
Journal of Southern Medical University
基金
2006年广东省科技厅科技计划项目(63004)~~
