Objective To investigate the similarities and differences of Fibro Scan in the diagnosis of liver fibrosis in patients with different chronic liver diseases. Methods The clinical data of 516 patients with chronic liver diseases who visited Peking University First Hospital from October 2012 to January 2015 were collected,and according to the cause of disease,these patients were divided into chronic hepatitis B( CHB) group( 305 patients),chronic hepatitis C( CHC) group( 117 patients),and primary biliary cirrhosis( PBC) group( 94 patients). The routine blood test results,liver function,Fibro Scan( FS) value,and abdominal ultrasound findings were recorded. The patients in each group were further divided into subgroups with FS value < 7. 3 k Pa,7. 3 k Pa ≤FS value < 15 k Pa,or FS value ≥15 k Pa.The Kruskal- Wallis H test was used for comparison of continuous data and categorical data between multiple groups,and the Mann- Whitney U test was used for comparison between any two groups. The multiple linear regression was used to analyze the correlation of FS value with age,sex,body mass index( BMI),routine blood test results,liver function,and ultrasound parameters. Results In the CHB group,sex,hemoglobin,aspartate aminotransferase( AST),albumin,alkaline phosphatase( ALP),total bilirubin( TBil),BMI,diameter of the portal vein,and ascites were the independent influencing factors for FS value( all P < 0. 05); in the CHC group,platelet count,alanine aminotransferase( ALT),ALP,gamma- glutamyl transpeptidase( GGT),total bile acid,smoothness of liver surface,diameter of the portal vein,and ascites were the independent influencing factors for FS value( all P < 0. 05); in the PBC group,TBil,total bile acid,and ascites were the independent influencing factors for FS value( all P < 0. 05). Most indicators showed significant differences between CHB and CHC patients with different FS values( all P < 0. 05). In the PBC group,only ALT( Z =- 2. 121,P = 0. 034),AST( Z =- 3. 027,P =0. 002),and spleen length( Z =- 2. 496,P = 0. 013) showed significant differences between the FS value < 7. 3 k Pa subgroup and the7. 3 k Pa ≤FS value < 15 k Pa subgroup; platelet count( Z =- 2. 289,P = 0. 022),albumin( Z =- 2. 185,P = 0. 029),TBil( Z =- 2. 642,P = 0. 008),spleen thickness( Z =- 3. 317,P = 0. 001),spleen length( Z =- 2. 010,P = 0. 044),and diameter of the splenic vein( Z =- 2. 296,P = 0. 022) showed significant differences between the 7. 3 k Pa ≤FS value < 15 k Pa subgroup and the FS value ≥15 k Pa subgroup. Conclusion Different factors affect the FS value in patients with different causes. Total bile acid and TBil are important influencing factors for FS value in PBC patients,while liver function greatly influences FS value in CHB and CHC patients,suggesting that the threshold values for Fibro Scan in the diagnosis of liver fibrosis should be set independently for different causes of disease.
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