FibroScan弹性值测定在HBV感染所致肝衰竭患者中的应用价值

目的：探讨FibroScan弹性值测定（简称FS）在乙型肝炎病毒（HBV）感染所致肝衰竭患者中的应用价值。方法：选择HBV感染所致肝衰竭患者45例，收集入院24h内的血常规、凝血和肝。肾功能等指标，入院第2d行FS和腹部B超检查，并计算患者B超评分、CTP评分和MELD积分。观察终点3个月，按预后良好和不良分为A、B2组，比较2组间各项检测指标间的差异。结果：偏相关分析提示FS值与预后呈密切正相关；双变量回归分析显示预后与FS值、肝衰竭分期、凝血功能等相关关系显著；2组间比较FS值差异有显著性意义（P〈0．05）。FS值与B超、CTP和MELD积分均呈正相关，对预后诊断价值较高，FS值测定影响较大的指标是INR、AST和TBIL。结论：FS值测定对HBV感染所致肝衰竭患者的短期预后有一定诊断价值，但受转氨酶和黄疸水平的影响。

Applied Value of FibroScan in Patients with Liver Failure Induced by HBV Infection

Objective： To investigate the clinical value of FibroSean in patients with liver failure induced by HBV infection. Methods：The clinical data of 45 inpatients with liver failure induced by HBV infection during the last 10 months were collected. All the patients received liver stiffness measure with FibroScan by the same doctor and ultrasonography. The follow-up period was 3 months. The ultrasonographic quantitative score, Child-Turcotte-Puge （CTP） and model for end-stage liver disease （MELD） scores were calculated in all patients. The 45 patients were divided into two groups, including eusemia group and unfavorable prognosis group. Results： Partial correlation showed significant positive correlation between liver stiffness measure and prognosis. Bivariate correlation indicated that liver stiffness, staging o{ liver failure and blood coagulation function had a significant correlation with prognosis. The liver stiffness measure had significant difference between two groups （P〈0. 05）. Using FibroScan, CTP and MELD had high diagnostic sensitivity and specificity on liver failure （all exceed 0.70）. There was good relation between liver stiffness measure and quantitative ultrasonographic score, clinical CTP or MELD scores. The level of INR, AST and TBIL had more effect on liver stiffness measure. Conclusion： FibroScan has diagnostic value in predicting the short-term （3 months） prognosis of patients with liver failure induced by HBV infection, but it is affected by the level of aminopherase and jaundice.