瞬时弹性成像可以定量评价肝纤维化病变程度

张医生

日本学者Ogawa等的一项研究表明，瞬时弹性成像（FibroScan）是评价乙肝病毒或丙肝病毒慢性感染者肝纤维化病变程度的有效方法。

研究纳入68例乙肝病毒感染者和161例丙肝病毒感染者。受试者均接受FibroScan检查、肝纤维化血清学标志物检查及肝活检。

结果显示，FibroScan检查结果与血清透明质酸和Ⅳ型胶原水平均显著正相关（r=0.601和r=0.663，均P<0.05）。F0～F4级的FibroScan结果中位数值，在慢性乙肝病毒感染者中分别为3.5kPa（F0级）、6.4kPa（F1级）、9.5kPa（F2级）、11.4kPa（F3级）和15.4kPa（F4级），在丙肝病毒感染者中分别为6.3kPa、6.7kPa、9.1kPa、13.7kPa和26.4kPa。各级FibroScan结果中位数值均与乙肝病毒感染者和丙肝病毒感染者的肝脏纤维化程度显著相关（乙肝病毒感染者：r=0.559，P=0.0093；丙肝病毒感染者：r=0.686，P<0.0001）。

Hepatol Res. 2007 Dec;37(12):1002-10.

Transient elastography for patients with chronic hepatitis B and C virus infection: Non-invasive, quantitative assessment of liver fibrosis.

Ogawa E, Furusyo N, Toyoda K, Takeoka H, Otaguro S, Hamada M, Murata M, Sawayama Y, Hayashi J.

Department of General Medicine, Kyushu University Hospital, Fukuoka, Japan.

Aim/Methods: The aim of the present study was to compare the diagnostic performance of transient elastography (FibroScan) with that of serum fibrosis markers and stages of hepatic fibrosis by biopsy in 68 patients with chronic hepatitis B virus (HBV) and in 161 patients with hepatitis C virus (HCV) infection. Results: The serum levels of hyaluronic acid (r = 0.601) and type IV collagen (r = 0.663) significantly positively associated with the FibroScan values (all P < 0.05). Classified by fibrosis stages, the median values of FibroScan were 3.5 kPa for F0, 6.4 kPa for F1, 9.5 kPa for F2, 11.4 kPa for F3, and 15.4 kPa forF4 in patients with chronic HBV infection, and were 6.3 kPa for F0, 6.7 kPa for F1, 9.1 kPa for F2, 13.7 kPa for F3, and 26.4 kPa for F4 in those with chronic HCV infection. The values were significantly correlated with fibrosis stage for both (HBV, r = 0.559, P = 0.0093, and HCV, r = 0.686, P < 0.0001). Conclusion: These results suggest that FibroScan is an efficient and simple method for evaluating liver fibrosis in patients with chronic infection, both for HBV and HCV.