FibroScan检测值与乙型肝炎肝硬化患者MELD评分相关性

目的了解乙型肝炎后肝硬化（LC）患者FibroScan检测值（FS值）与MELD评分之间的相关性,评价FS对疾病严重程度的诊断能力。方法选取我院170例行FibroScan检测的LC患者,获取FS值、肝功能、肾功能、凝血指标和临床诊断数据,计算MELD评分,经统计学检验明确FS值与MELD评分之间相关性。结果临床诊断代偿期LC141例（LC-C组）;失代偿期LC29例（LC-D组）。两组FS值及MELD评分差异均有统计学意义（P均〈0.001）。对FS值与MELD评分之间进行Spearman相关分析,相关系数0.458,差异有统计学意义（P〈0.001）。以FS值15kPa为临界值,将患者分2组（FS值〈15kPa,63例;FS值≥15kPa,107例）。对两组患者MELD值进行非参数Mann-Whitney检验,提示差异有统计学意义。如以FS值≥15kPa诊断失代偿期LC患者,则其灵敏度、特异度、阳性预测值和阴性预测值分别为86.2%、41.8%、23.4%、93.7%。结论 FibroScan与患者MELD值相关性较好,在乙型肝炎肝硬化病情严重程度方面有较好的应用价值。FS值〈15kPa则失代偿期肝硬化可能性较小。

The correlation of FibroScan with MELD score in patients with HBV-related cirrhosis

Objective To evaluate the correlation of FibroScan（FS） with MELD score in patients with HBV-related cirrhosis（LC）.Methods One hundred and seventy patients with LC were included in this study.Clinical data and laboratory tests including liver function,renal function,INR,FS value were collected and analyzed.Results One hundred and forty-one patients were diagnosed as compensated LC（LC-C）.Twenty-nine patients were diagnosed as decompensate LC（LC-D）.FS values and MELD score between two groups have showed significant difference respectively（P0.001）.Spearman correlation analysis showed that the coefficient correlation between FS value and MELD score was 0.458（P0.001）.The patients were divided into two groups according to FS cut-off value（FS 15 kPa group and FS ≥15 kPa group）.MELD score between two groups had showed significant difference（P0.001）,and if FS≥15 kPa was used for diagnosis of LC-D,the sensitivity,specificity,positive predictive value and negative predictive value were 86.2%,41.8%,23.4%,93.7% respectively.Conclusion FS value correlates with MELD score in patients with HBV-related cirrhosis,which is valuable to judge severity of cirrhosis.Patients with FS values under 15 kPa have a small chance to develop decompensate cirrhosis.