肝脏瞬时弹性超声评价自身免疫性肝炎肝纤维化的价值

目的 验证肝脏瞬时弹性超声在评估自身免疫性肝炎(AIH)患者肝纤维化程度中的价值.方法 用瞬时弹性超声对30例AIH患者进行肝脏瞬时弹性测定,并将测定值与按照Scheuer系统进行纤维化分级的患者肝活组织检查结果作纤维化程度的比较,用Spearman等级相关系数方法进行统计学分析.结果 30例AIH患者中S0期4例,S1期6例,S2期5例,S3期11例,S4期4例.除l例患者因肥胖导致瞬时弹性超声检测失败以外,其余均顺利受检.29例患者测定的瞬时弹性超声硬度值与其肝纤维化分期有显著相关性(r= 0.801,P＜0.01).将S0、S1、S2期合并与S3、S4期合并后对两组间瞬时弹性超声硬度值作比较,t= -3.937,P=0.001,差异有统计学意义.结论 肝脏瞬时弹性超声评估AIH患者肝纤维化程度的可靠性较好,并且由于其无创性而在此类患者的长期随访与疗效评估中有着较好的应用前景.

Validation of transient elastography (Fibroscan) in assessment of hepatic fibrosis in autoimmune hepatitis

Objective To validate transient elastography (Fibroscan) in assessment of hepatic fibrosis in autoimmune hepatitis (AIH).Methods Liver stiffness was assessed using Fibroscan in totally 30 patients with AIH.We compared the results of Fibroscan with the Scheuer fibrosis stage in liver biopsy in each patient.Results 4 patients were shown as liver fibrosis stage S0,6 as S 1,5 as S2,11 as S3 and 4 as S4.Failure of the Fibroscan measurement occurred in 1 case (3.3％) because of her increased body mass index (BMI).The stiffness of Fibros can was significantly correlated with the liver biopsy fibrosis stage (r= 0.801,P＜0.001).The liver stiffnesses between mild and moderate fibrosis (S0-2) and advanced fibrosis (S3-4) were significantly different (t=-3.937,P= 0.001).Conclusion Transient elastography (Fibroscan) is a promising non-invasive method for detection of fibrosis in patients with autoimmune hepatitis.Its use for the follow up and management of these patients and should be evaluated further.