【摘要】：目的:探討使用Fibro Scan受控衰減參數(shù)(Controlled attenuation parameters,CAP)無創(chuàng)定量評估慢性乙肝患者肝臟病損程度(肝組織炎癥、纖維化和脂肪變)。材料方法:選取2013年9月-2015年1月底期間入住我院的80例慢性乙型病毒性肝炎患者,同時進行Fibro Scan超聲波瞬時彈性成像測量CAP值及肝穿刺活檢。運用t檢驗、相關(guān)性檢驗和ROC曲線分析驗證CAP值評估肝損傷方法的敏感度和特異性。結(jié)果:慢性乙肝患者CAP值與肝組織炎癥分級與纖維化分期呈顯著性負相關(guān)(r=-0.34,p0.05),而CAP值與患者肝臟脂肪變程度分級呈明顯正相關(guān)(r=0.4197,p0.01)。輕度和中重度的炎癥、肝脂肪變的慢性乙肝患者之間的CAP值有顯著差異性(p0.05)。以分級指數(shù)≥2作為診斷中重度炎癥、纖維化和脂肪化的標(biāo)準(zhǔn),CAP值與炎癥指數(shù)、纖維化指數(shù)和脂肪變指數(shù)的ROC曲線下面積(AUC)分別為0.8405、0.8205、0.9101,表明CAP值能準(zhǔn)確評估肝損傷。閾值分析表明,CAP值194 d B/m能將肝組織輕度和中重度炎癥區(qū)分開,方法的敏感度和特異性,分別為81%和89%。以CAP值236 d B/m為診斷閾值,能將肝組織輕度和中重度纖維化區(qū)分開,方法敏感度和特異性分別為79%和85%。CAP閾值為267 d B/m能將肝組織輕度和中重度脂肪病變區(qū)分開,方法敏感度和特異性分別為85%和91%。結(jié)論:Fibro Scan CAP值能準(zhǔn)確區(qū)分慢性乙肝患者肝組織輕度和中重度炎癥、纖維化和肝脂肪變程度,可用于無創(chuàng)定量評價慢性乙肝患者肝臟病損程度。
[Abstract]:Objective: to evaluate the degree of liver lesion (inflammation, fibrosis and fatty degeneration) in patients with chronic hepatitis B by using Fibro Scan controlled attenuation parameter (Controlled attenuation parameters,CAP). Materials: 80 patients with chronic viral hepatitis B were selected from September, 2013 to January, 2015, and the CAP value and liver biopsy were measured by Fibro Scan. T test, correlation test and ROC curve analysis were used to verify the sensitivity and specificity of CAP value in evaluating liver injury. Results: there was a significant negative correlation between CAP and liver inflammation grade and fibrosis stage (r = -0.34, p 0.05), but a positive correlation between CAP value and hepatic steatosis grade (r = 0.4197, p 0.01). There was a significant difference in CAP between mild and moderate inflammation, liver fat and chronic hepatitis B patients (p0. 05). Using grading index 鈮，

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