受控衰减参数和肝脏硬度检测对肝纤维化的评估价值

Evaluation value of controlled attenuation parameter and liver stiffness measurement for liver fibrosis

摘要:

目的研究受控衰减参数(CAP)和肝脏硬度(LSM)检测对肝纤维化的评估价值。方法选取乙型肝炎病毒(HBV)感染患者92例为HBV组,同期30例体检健康者为健康组。HBV组均行肝穿刺活检,比较不同程度肝纤维化HBV感染患者的LSM和CAP。采用Spearman法分析LSM、CAP与血清HBV DNA载量、丙氨酸氨基转移酶(ALT)的相关性,ROC分析LSM、CAP对不同程度肝纤维化HBV感染的诊断效能。结果HBV组CAP、LSM均高于健康组,不同肝纤维化分期CAP、LSM比较差异有显著性(P＜0.05)。HBV组患者CAP、LSM与血清HBV DNA载量、ALT呈正相关(P＜0.05)；CAP、LSM鉴别轻、重度肝纤维化的AUC分别为0.826(P＜0.001)和0.797(P＜0.001)。结论LSM、CAP对HBV感染患者轻、重度肝纤维化有较好的鉴别效能,对临床肝纤维化的诊断评估有重要意义。

Abstract:

To study the evaluation value of controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) for liver fibrosis. MethodsA total of 92 patients with hepatitis B virus (HBV) infection were enrolled as HBV group, while other 30 healthy controls during the same period were enrolled as healthy group. All patients in HBV group underwent liver biopsy. LSM and CAP among HBV infection patients with different degree of liver fibrosis were compared. The correlation between LSM, CAP and load of serum HBV DNA, alanine aminotransferase (ALT) was analyzed by Spearman. The diagnostic efficiency of LSM and CAP for HBV infection with different degree of liver fibrosis was analyzed by ROC curves. ResultsCAP and LSM in HBV group were higher than those in healthy group. The differences in CAP and LSM among patients with different liver fibrosis stages were statistically significant (P＜0.05). CAP and LSM were positively correlated with load of serum HBV DNA and ALT (P＜0.05). AUC values of CAP and LSM in the differential diagnosis of mild and severe liver fibrosis were 0.826 (P＜0.001) and 0.797 (P＜0.001), respectively. ConclusionLSM and CAP have good differential efficiency for mild and severe liver fibrosis in patients with HBV infection, which are of great significance for the clinical diagnosis and evaluation of liver fibrosis.