摘要
目的探讨慢性乙型肝炎(chronichepatitisB,CHB)患者血清肝纤维化4项水平,联合Fibroscan(FS)诊断肝脏纤维化的临床意义。方法选取CHB患者54例作为研究组,以病理结果为金标准,运用FS检测肝脏硬度值(LSM),检测肝脏纤维化四项:透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原肽(PⅢNP)和Ⅳ型胶原(Ⅳ-C);分析四项水平及LSM等指标单独和联合诊断的ROC及AUC,探讨其在肝脏纤维化诊断中的价值。结果以病理学分为无肝纤维化组(S0),肝纤维化组(S≥1)和显著肝纤维化组(S≥2);与S0相比,S≥1HA明显升高(P<0.05);S≥2HA、Ⅳ-C明显升高,差异均有统计学意义(P<0.05)。以S0为阴性对照,S≥1为阳性对照,肝脏纤维化四项判断肝纤维化AUC为0.661,肝脏纤维化四项联合FS判断肝纤维化AUC为0.669。以S0为阴性对照,S≥2为阳性对照,肝脏纤维化四项联合判断肝纤维化AUC为0.779,肝脏纤维化四项联合FS判断肝纤维化AUC为0.813。结论肝脏纤维化四项对肝纤维化的诊断有一定筛查和预警作用,联合FS对肝脏纤维化的诊断、治疗及效果评价具有重要作用。
Objective To investigate the clinical significance of four markers of liver fibrosis combined with Fibroscan(FS) in the diagnosis of liver fibrosis in chronic hepatitis B(CHB) patients.Methods Fifty four patients with CHB were selected as the study group. With pathological results as gold standard,liver stiffness measurement( LSM) was detected by Fibroscan,and hyaluronic acid(HA) ,laminin(LN) ,type Ⅲ procollagen peptide(PⅢNP) and type Ⅳ collagen(Ⅳ- C) were detected.ROC and AUC in single detection or combined detection of the four markers and LSM were analyzed to explore the value in diagnosing liver fibrosis.Results All cases were pathologically divided into non - liver fibrosis group(S0) ,liver fibrosis group(S≥1) and significant liver fibrosis group (S≥2) ; compared with S0,S≥1 HA significantly increased (P< 0.05) ; S≥2 HA and IV - C significantly increased,with the differences statistically significant (P<0.05) .With S0 as the negative control,S≥1 as positive control,AUC of the four markers in diagnosing liver fibrosis was 0.661,and that of the four markers combined with FS was 0.669. With S0 as negative control,S≥2 as positive control,AUC of the four markers was 0.779,and that of the four markers combined with FS was 0.813. Conclusion Hepatic fibrosis has a certain screening and early warning function for the diagnosis of liver fibrosis. The four markers combined with FS plays an important role in the diagnosis,treatment and evaluation of liver fibrosis.
作者
徐长志
唐奇远
周文营
董慧敏
胡波
XU Chang -zhi;TANG Qi -yuan;ZHOU Wen -ying;DONG-Hui-min;HU Bo(Clinical Laboratory,the Third Affiliated Hospital of Sun Yat -sen University,G uangzhou,Guangdong 510630,China)
出处
《中国卫生检验杂志》
CAS
2018年第24期3006-3008,3011,共4页
Chinese Journal of Health Laboratory Technology
关键词
慢性乙型肝炎
肝脏纤维化四项
弹性超声
肝纤维化
Chronic hepatitis B
Four serum markers for hepatic fibrosis
Fibroscan
Liver fibrosis
