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FibroTouch®对不同BMI水平非酒精性脂肪性肝病患者肝纤维化程度的评估比较
Efficiency of FibroTouch in evaluating liver fibrosis degree in nonalcoholic fatty liver disease patients with different levels of body mass index
文章发布日期:2018年08月06日  来源:  作者:冷雪君,颜学兵  点击次数:264次  下载次数:16次

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【摘要】:目的观察Fibrotouch无创肝脏硬度测定(LSM)对不同BMI水平的非酒精性脂肪肝病(NAFLD)患者肝纤维化程度的临床评估效能。方法纳入2015年6月-2018年1月徐州医科大学附属医院收治且进行肝穿刺活组织检查的238例NAFLD患者, 依据BMI水平分成3组(BMI<24、24≤BMI<28及BMI≥28),于肝穿刺后1周内进行FibroTouch检测并于当日空腹进行血样采集,应用计算公式获得各肝纤维化评分指标。分析不同BMI水平组LSM值对肝纤维化程度的评估效能,并分析LSM值与相关血清学肝纤维化指标的相关性,构建受试者工作特征(ROC)曲线,应用曲线下面积(AUC)评价其诊断价值。不同程度肝纤维化NAFLD患者间各项指标的差异采用单因素方差分析及SNK-q法检验;非正态分布资料多个独立样本间比较采用Kruskal-Wallis H检验。LSM值与其他指标的相关性采用Spearman秩相关分析。结果相同BMI水平的NAFLD患者其LSM值在不同肝纤维化程度间差异均有统计学意义(F值分别为18.543、22.985、5.904,P值分别为<0.001、<0.001、0.004);对进展性肝纤维化NAFLD患者,不同BMI组间的LSM值差异有统计学意义(F=3.899,P=0.026);LSM值与纳入的4项肝纤维化诊断模型Hui氏评分、Forns指数、FIB-4、NFS均有较好的相关性(r值分别为0.459、0.388、0.427、0.422,P值均<0.001);LSM值诊断NAFLD进展性纤维化的临床效用最高,其AUC为 0.870,特异度和灵敏度分别是86%和70%。结论FibroTouch评估NAFLD肝纤维化程度具有良好的应用价值,BMI水平可在一定程度上影响LSM结果;LSM值与各纤维化诊断指标具有较好的相关性,值得临床进一步推广应用。
【Abstract】:ObjectiveTo investigate the efficiency of FibroTouch noninvasive liver stiffness measurement (LSM) in evaluating liver fibrosis degree in nonalcoholic fatty liver disease (NAFLD) patients with different levels of body mass index (BMI). MethodsA total of 238 NAFLD patients who were admitted to The Affiliated Hospital of Xuzhou Medical University from June 2015 to January 2018 and underwent liver biopsy were enrolled in this study, and according to BMI, they were divided into group A (BMI <24), group B (24≤BMI<28), and group C (BMI≥28). FibroTouch was performed within one week after liver biopsy, and fasting blood samples were collected on the same day. The fibrosis indices were calculated. The efficiency of LSM in evaluating fibrosis degree was analyzed in all groups, and the correlation of LSM with related serological fibrosis indices was analyzed. The receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was used to evaluate the diagnostic value of LSM and serum markers. A one-way analysis of variance and the SNK-q test were used to investigate the differences in related indices between NAFLD patients with varying fibrosis degrees, and the Kruskal-Wallis H test was used for comparison of non-normally distributed data. The Spearman′s rank correlation analysis was used to investigate the correlation between LSM and other indices. ResultsIn group A, B, or C, there was a significant difference in LSM between the NAFLD patients with different fibrosis degrees (F=18.543, 22.985, and 5.904, P<0.001, P<0.001, and P=0.004). In the NAFLD patients with progressive liver fibrosis, there was a significant difference in LSM between the patients with different levels of BMI (F=3.899, P=0.026). LSM was correlated with Hui score, Forns index, fibrosis-4, and NAFLD fibrosis score (r=0.459, 0.388, 0427, and 0.422, all P<0.001). LSM had the highest efficiency in the diagnosis of progressive liver fibrosis in NAFLD patients, with an AUC of 0.870, a specificity of 86%, and a sensitivity of 70%. ConclusionFibroTouch has good value in evaluating the liver fibrosis degree of NAFLD patients, and BMI may affect the result of LSM. LSM is well correlated with other diagnostic indices for liver fibrosis and holds promise for clinical application.
【关键字】:非酒精性脂肪性肝病; 肝硬化; 人体质量指数; 诊断
【Key words】:non-alcoholic fatty liver disease; liver cirrhosis; body mass index; diagnosis
【引证本文】:LENG XJ, YAN XB. Efficiency of FibroTouch in evaluating liver fibrosis degree in nonalcoholic fatty liver disease patients with different levels of body mass index[J]. J Clin Hepatol, 2018, 34(9): 1891-1895. (in Chinese)
冷雪君, 颜学兵. FibroTouch对不同BMI水平非酒精性脂肪性肝病患者肝纤维化程度的评估比较[J]. 临床肝胆病杂志, 2018, 34(9): 1891-1895.

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