FibroScan检测与超声检查对肝纤维化程度诊断价值的对比分析

刘玲峰; 陆海英; 于岩岩; 吴赤红; 田秀兰

doi:10.3969/j.issn.1001-5256.2014.10.018

FibroScan检测与超声检查对肝纤维化程度诊断价值的对比分析

DOI: 10.3969/j.issn.1001-5256.2014.10.018

北京大学第一医院感染疾病科

基金项目:

国家十二五科技重大专项资助项目(2012ZX10002003)；

详细信息

中图分类号: R575.2
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出版历程
- 收稿日期: 2014-06-03
- 出版日期: 2014-10-20

A comparative study of FibroScan and B ultrasound in diagnosis of liver fibrosis

Department of Infectious Diseases, Peking University First Hospital

Research funding:

摘要

摘要:
目的探讨FibroScan与超声检查诊断肝纤维化的异同性及关联性。方法以2012年10月-2014年2月就诊于本院的慢性HBV感染患者（305例）、慢性HCV感染患者（96例）及原发性胆汁性肝硬化（31例）为研究对象,记录患者肝脏弹性值（FS）及腹部B超的肝左叶厚、肝右叶厚、门静脉内径、脾厚、脾长、脾静脉内径、肝血管走形指标的检查结果,以及腹水、脂肪肝、胆囊疾病及肝硬化的发生率。采用Spearman相关性分析、多重线性回归分析进行FS与各项观察指标的相关性检验。不同FS值等级间各项指标的比较采用Kruskal-Wallis H检验或Mann-Whitney U检验。结果 FS值（r=0.2490.543,P<0.05）及FS值等级（r=0.2290.541,P<0.05）均与肝左叶厚径、脾脏长度和厚度、门静脉内径、脾静脉内径、肝表面光滑度、实质回声、血管走形清晰程度、腹水、肝硬化呈正相关;多重线性回归分析显示肝表面光滑度、肝左叶厚径、腹水、门静脉内径是FS值的独立影响因素（t值分别为5.123,3.703,3.113,2.985,...
- 肝硬化 /
- 超声检查 /
- FibroScan /
- 诊断
Abstract:
Objective To compare the diagnostic performances of FibroScan ( FS) and B ultrasound for liver fibrosis and assess the relationship between the two methods. Methods The clinical data of 432 patients who were admitted to our institution between October 2012 and February 2014 were retrospectively analyzed. Of them, 305 had chronic hepatitis B virus infection, 96 had chronic hepatitis C virus infection, and 31 had primary biliary cirrhosis. FS values and parameters measured by B ultrasound including the thickness of left and right liver lobes, the diameter of the portal vein, spleen thickness, spleen length, the diameter of the splenic vein, and variables describing vascular morphology of the liver were recorded. Additionally, the incidence rates of ascites, fatty liver disease, gallbladder diseases, and liver cirrhosis were also reviewed. The correlations between FS value and the parameters were explored using the Spearman rank correlation test and multiple linear regression model. Patients were categorized based on FS values; parameters were compared between the groups by use of Kruskal-Wallis H test or Mann-Whitney U test. Results FS value was positively correlated with the thickness of left liver lobe, spleen thickness and length, the diameter of the portal vein, the diameter of the splenic vein, liver surface smoothness, parenchymal echo, vascular morphology, ascites ( presence or absence) , and liver cirrhosis ( presence or absence) ( rs= 0. 249-0. 543, P < 0. 05 for all) . Furthermore, positive correlations were also observed between these parameters and the stage of liver fibrosis as determined based on FS values ( rs= 0. 229-0. 541, P < 0. 05 for all) . Multiple linear regression analysis identified liver surface smoothness, thickness of the left liver lobe, ascites, and diameter of the portal vein as independent predictive factors for FS value ( t = 5. 123, 3. 703, 3. 113, and 2. 985, P <0. 05 for all) . FS values were 9. 573 ± 9. 490 kPa, 16. 339 ± 11. 359 kPa, and 27. 688 ± 18. 676 kPa in the three groups with liver echo enhancement, rough echo, and nodular echo, respectively; differences between the groups were significant ( χ2= 98. 469, P = 0. 000) .Conclusion There are reliable correlations between FS value and parameters measured by B ultrasound. The diagnostic performance of FibroScan for liver fibrosis is more accurate and objective than that of B ultrasound.
- liver cirrhosis /
- ultrasonography /
- FibroScan /
- diagnosis

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参考文献(17)

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