Fibro Scan 与超声检查诊断肝纤维化的异同性及关联性

【目的】探讨FibroScan检查（FS检查）与超声检查（US检查）在诊断慢性肝病患者肝纤维化的异同性和相关性。【方法】选取2014年1月至2015年5月在院诊治的慢性肝病患者382例作为研究对象，其中慢性乙型肝炎（HBV ）感染260例，慢性丙型肝炎82例，原发性胆汁性肝硬化40例。分别采用FS检查和U S检查两种方法对肝脏、脾脏等器官及其血管分布等进行测定，并采用Spearman相关性分析、多重线性回归分析对各项检测指标，特别是FS检查的肝硬度值（FS值），进行相关性分析。【结果】US检查结果显示，慢性乙型肝炎患者、慢性丙型肝炎患者、原发性胆汁性肝硬化患者的肝左叶厚度、肝右叶厚度、门静脉内径、肝脏血管走形、胆囊疾病及脂肪肝发病率等差异无统计学意义（ P ＞00．5）；三组患者的FS值分别为（95．74±94．91）kPa、（163．38±113．58）kPa、（276．87±186．77）kPa ，三组患者间差异无统计学意义（ P ＞00．5），各组间两两比较差异均有统计学意义（ P ＜00．5）；原发性胆汁性肝硬化患者肝脏表面光滑度、肝脏回声状况差于慢性乙型肝炎患者和慢性丙型肝炎患者，肝硬化发生率明显高于后两组患者（ P ＜00．5）；FS值与肝左叶厚度、门静脉内径、肝脏表面光滑度、肝脏回声、肝脏血管走形、肝硬化等成正相关（ P ＜00．1），与胆囊疾病发生率呈负相关（ P ＜00．1）；FS值与超声检测结果的回归性分析显示，肝脏表面光滑度、肝左叶厚径和门静脉内径，各个偏回归系数差异均有统计学意义（ P ＜00．5）。【结论】FS检查与US检查具有较好的相关性，在临床工作中结合US和Fibroscan检查结果进行综合分析，能更好对肝病患者肝纤维化程度做出准确评估，更好的指导临床治疗。

Similarities and Differences between FibroScan and Ultrasonography in the Diagnosis of Hepatic Fibrosis

Objective]To investigate the similarities and differences of FibroScan(FS) and ultrasonography(US) in the di‐agnosis of hepatic fibrosis .Methods]Three hundred and eighty‐two patients with chronic liver diseases from January 2014 to May 2015 were collected as the research objects ,including 260 cases of chronic hepatitis B (HBV) ,82 cases of chronic hepati‐tis C(HCV) ,and 40 cases of primary biliary cirrhosis .Data was collected through detecting with FibroScan examination and abdominal ultrasound examination of liver ,spleen ,and other organs and their blood vessel distribution ,especially FS value , and analyzed using Spearman correlation and multiple linear regression .Results]Ultrasound examination results show that the differences in right hepatic leaf thickness ,left hepatic leaf thickness ,diameter of portal vein ,liver vascular shape ,gallbladder disease and the incidence of fatty liver ,etc .had no statistical significance ( P >0 0.5) among patients with chronic hepatitis B , chronic hepatitis C ,and primary biliary cirrhosis .FibroScan showed the FS values in HBV ,HCV and primary biliary cirrhosis patients were (9 5.74 ± 9 4.91)kPa、(16 3.38 ± 11 3.58)kPa、(27 6.87 ± 18 6.77)kPa ,respectively .There were no statistically signif‐icant differences among the three groups( P >0 0.5) ,however ,significant differences showed in between two groups( P <0 0.5) .The liver surface smoothness degree and the echo of liver condition in primary biliary cirrhosis patients were lower ,but the incidence of cirrhosis was higher than those of patients in the other two groups ( P <0 0.5) .Detection of FS values and left hepatic leaf thickness ,diameter of portal vein ,liver surface smoothness degree ,the echo of liver ,liver vascular shape ,and cir‐rhosis of the liver were positively correlated ( P <0 0.1) ,but the occurring rate of gallbladder diseases was negatively correla‐ted with FS values ( P <0 0.1) .The regression analysis of FibroScan and ultrasonic test showed that the differences in liver surface smoothness degree ,the thickness of the left lobe of the liver ,the diameter of the portal vein ,and the regression coeffi‐cients were statistically significant ( P <0 0.5) .Conclusion]FS and US inspection check had good correlation ,and the combi‐nation of both results and comprehensive analysis made a more accurate assessment of the severity of liver fibrosis in patients with liver disease to better guide clinical treatment .FibroScan examination and ultrasound examination has good correlation ,but FibroScan has more obvious advantages in the diagnosis of liver fibrosis .