摘要
目的探讨Fibro Touch、FIB-4指数、APRI指数3种肝纤维化无创诊断技术对慢性乙型肝炎(CHB)肝纤维化评估的价值。方法纳入2013年9月-2015年5月在新疆维吾尔自治区中医医院就诊的148例行肝穿刺活组织检查的CHB患者,以肝纤维化分期分组,均进行血生化、血常规、Fibro Touch检测,计算FIB-4指数和APRI指数,记录肝脏硬度值,应用受试者工作特征曲线(ROC)分析方法计算曲线下面积(AUC),确定截断值、敏感度和特异度。两组间比较采用χ2检验;相关性检验采用Pearson等级相关分析。结果 Fibro Touch、APRI和FIB-4指数3种无创诊断方法与肝纤维化分期具有良好的相关性(r值分别为0.628、0.486、0.482,P值均<0.01)。Fibro Touch对明显肝纤维化组(≥S2)、肝硬化组(S4)的诊断性能最好,AUC分别为0.84、0.93;其次为APRI指数,AUC分别为0.79、0.87;FIB-4指数诊断性能相对较差,AUC分别为0.77、0.84。对于肝纤维化分期≥S2及S4,FibroTouch诊断价值均优于APRI及FIB-4指数(Z=21.589,P<0.001;Z=18.896,P<0.001;Z=11.192,P=0.001;Z=16.891,P<0.001),APRI指数诊断价值优于FIB-4指数(Z值分别为46.918、35.334,P值均<0.001)。结论 Fibro Touch可以较准确地评估CHB患者有无肝纤维化及肝纤维化程度,使多数患者避免有创性肝穿刺活组织检查。
Objective To investigate the values of Fibro Touch,FIB- 4 index,and aspartate aminotransferase- to- platelet ratio index（ APRI） in the diagnosis of liver fibrosis in patients with chronic hepatitis B（ CHB）. Methods A total of 148 patients with CHB who visited Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region and underwent liver biopsy from September 2013 to May2015 were enrolled and divided into groups according to fibrosis stage. All the patients underwent blood biochemical examination,routine blood tests,and Fibro Touch measurement. Then FIB- 4 and APRI were calculated,and liver stiffness was recorded. The receiver operating characteristic（ ROC） curve was used to calculate the area under the ROC curve（ AUC） and determine the cut- off value,sensitivity,and specificity. Chi- square test was used for comparison between two groups,and the Pearson rank correlation analysis was also performed. Results Fibro Touch,APRI,and FIB- 4 were well correlated with fibrosis stage（ r = 0. 628,0. 486,and 0. 482,respectively,all P〈0. 01）.In the marked liver fibrosis（ ≥S2） group and liver cirrhosis（ S4） group,Fibro Touch had the best diagnostic performance,with AUCs of 0. 84 and 0. 93,respectively,followed by APRI,which had AUCs of 0. 79 and 0. 87,respectively; FIB- 4 index had the worst diagnostic performance,with AUCs of 0. 77 and 0. 84,respectively. In patients with a fibrosis stage of ≥S2 or S4,Fibro Touch had a better diagnostic value than APRI and FIB- 4（ Z = 21. 589,P〈0. 001; Z = 18. 896,P〈0. 001; Z = 11. 192,P = 0. 001; Z = 16. 891,P〈0. 001）,and APRI had a better diagnostic value than FIB- 4（ Z = 46. 918,P〈0. 001; Z = 35. 334,P〈0. 001）. Conclusion Fibro Touch can accurately evaluate the presence of liver fibrosis and fibrosis degree and help most patients avoid invasive liver biopsy.
出处
《临床肝胆病杂志》
CAS
2016年第8期1508-1512,共5页
Journal of Clinical Hepatology
基金
新疆医科大学科研创新基金(ZYY201325)
关键词
肝硬化
肝炎
乙型
慢性
诊断技术和方法
对比研究
liver cirrhosis
hepatitis B
chronic
diagnostic techniques and procedures
comparative study
