Fibroscan在乙肝相关肝纤维化诊断中的临床应用研究

目的 探讨Fibroscan(FS)在乙肝相关肝纤维化诊断中的临床应用价值。方法 对已进行肝活检的59例乙肝患者测定其硬度（stiffness）值，同时进行血清纤维化四项透明质酸（HA）、层粘连蛋白（LN）、三型前胶原（PⅢP）、四型胶原（CV-IV）的检测，应用受试者工作特征（ROC）曲线分析方法，以肝活检病理学结果为金标准对FS及血清纤维化四项临床价值进行分析。结果 随着肝纤维化程度的提高，stiffness值有显著升高，与病理学结果存在良好的相关性,r=0.76（P=0.00），ROC曲线分析stiffness、 HA 、LN 、PⅢP、CV IV曲线下面积分别为0.98、0.82、0.74、0.59、0.76，FS灵敏度及特异度均高于血清纤维化四项检测。结论 FS是乙肝相关肝纤维化诊断中非常有效的一种检查手段。

Fibroscan in the diagnosis of hepatitis B related fibrosis

Objective     To investigate the clinical value of fibroscan (FS) in the diagnosis of hepatitis B related fibrosis. Methods     Stiffness, hyaluronic acid(HA), laminin(LN), propeptide type Ⅲ of procollagen (PⅢP) and collagen Type Ⅳ(CV-IV) were detected in 59 chronic hepatitis B patients having undergone liver biopsy. The diagnostic values of FS and serum liver fibrosis markers were tested by the receiver operating characteristic (ROC) curve, using liver biopsy as the  gold standard. Results    In patients with moderate or serious fibrosis, the stiffness value was significantly high, and correlated with the fibrosis degree （r=0.76, P=0.00）.The ROC curve analysis showed that the areas under the curve for stiffness, HA, LN, PⅢP and CV-IV were 0.98, 0.82, 0.74, 0.59 and 0.76 respectively. The sensitivity and specificity for  stiffness were higher than those with serum liver fibrosis markers. Conclusion    FS is an effective method in the diagnosis of hepatitis B related fibrosis.