非酒精性脂肪性肝炎患者肝脏受控衰减参数的变化

doi:10.3969/j.issn.1672-5069.2021.02.016

摘要/Abstract

摘要： 目的探讨瞬时弹性记录仪(FibroScan)检测肝脏受控衰减参数(CAP)诊断非酒精性脂肪性肝炎(NASH)的效能。方法 2016年1月～2020年1月我院收治的NASH患者142例和同期健康体检者130例,使用FibroScan检测肝脏CAP值。采用受试者工作特征曲线(ROC)并计算曲线下面积(AUC)评价CAP值诊断NASH的效能。结果 NASH组CAP值为(291.1±94.5)dB/m,显著高于健康人【(216.2±43.1)dB/m,P＜0.001】;60例NAS积分4分者、39例5分者、27例6分者和16例7分者CAP值分别为(247.4±20.4)dB/m、(282.4±25.2)dB/m、(352.4±31.4)dB/m和(372.4±27.0)dB/m,P＜0.001】;经ROC曲线分析,结果显示CAP值诊断NASH的AUC为0.865(标准误0.025,P＜0.001,95%CI=0.815～0.915),诊断NASH的截断点为293.7 dB/m,其敏感度为0.831,特异度为0.885。结论使用FibroScan检测肝脏CAP能无创性定量评价NASH病变程度,对临床早期筛查NASH具有重要的价值。

关键词: 非酒精性脂肪性肝炎, 瞬时弹性记录仪, 受控衰减参数, 诊断

Abstract: Objective The purpose of this study was to investigate the early screening of nonalcoholic steatohepatitis (NASH) detected by FibroScan with liver controlled attenuation parameters (CAP) .Methods 142 patients with NASH and 130 healthy individuals were recruited in our hospital between January 2016 and January 2020,and underwent Fibroscan for CAP. All patients received liver biopsies and the nonalcoholic fatty liver disease activity score (NAS) was defined. The area under the receiver operating characteristic curve (AUROC)was obtained for evaluating the diagnostic efficacy of CAP in predicting NASH.Results The cap in patients with NASH was (291.1±94.5) dB / m, which was significantly higher than that in healthy persons [(216.2±43.1) dB/m, P<0.001]; the cap values in 60 patients with NAS of four, 39 patients with NAS of five, 27 patients with NAS of six and 16 patients with NAS of seven were (247.4±20.4)dB/m, (282.4±25.2)dB/m, (352.4±31.4)dB/m and (372.4±27.0)dB/m,P＜0.001】, significantly different among them; the ROC analysis showed that the AUC of CAP was 0.865(SE:0.025, 95%CI=0.815-0.915, P＜0.001), with optimal cut-off-value of 293.7 dB/m, and the sensitivity of 0.831 and specificity of 0.885.Conclusion The CAP might help quantitatively screening Nash in physical examination, and warrants further investigation.

Key words: Nonalcoholic steatohepatitis, Transient elastography, Controlled attenuation parameter, Diagnosis

杨振辉, 古宝欢, 戴小灵. 非酒精性脂肪性肝炎患者肝脏受控衰减参数的变化[J]. 实用肝脏病杂志, 2021, 24(2): 212-215.

Yang Zhenhui, Gu Baohuan, Dai Xiaoling. Early screening of nonalcoholic steatohepatitis by FibroScan with liver controlled attenuation parameters[J]. Journal of Practical Hepatology, 2021, 24(2): 212-215.

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