控制衰减参数为脂肪肝无创性评估使用Fibroscan®：慢性乙型肝

StephenW

Digestive Diseases and Sciences
January 2015, Volume 60, Issue 1, pp 243-251
Date: 07 Sep 2014
Controlled Attenuation Parameter for Noninvasive Assessment of Hepatic Steatosis Using Fibroscan®: Validation in Chronic Hepatitis B

    Yu-Qiang Mi,
    Qi-Yu Shi,
    Liang Xu,
    Rui-Fang Shi,
    Yong-Gang Liu,
    Ping Li,
    Feng Shen,
    Wei Lu,
    Jian-Gao Fan


Abstract
Background and Aim

The controlled attenuation parameter (CAP) using transient elastography (TE) was validated in chronic hepatitis C to evaluate hepatic steatosis; however, limited data are available on chronic hepatitis B (CHB). Therefore, we assessed the accuracy and the efficacy of CAP for the detection of steatosis in CHB.
Methods

Consecutive CHB patients underwent liver biopsy and liver stiffness measurements (LSM) with simultaneous CAP determination using the M probe of the TE. The area under the receiver operating characteristics curve (AUROC) was used to evaluate the performance of CAP in diagnosing steatosis compared with biopsy.
Results

A total of 340 patients were included: 60 % were male, the median age was 37 years; the body mass index (BMI) was ≥28 kg/m2 for 14 % of the subjects; and the distribution of the steatosis grade was S0 58.2 %, S1 34.2 %, S2 5.0 % and S3 2.6 %. The median (range) of CAP was 218 (100–400) dB/m, and CAP correlated with the BMI (ρ = 3.622) and steatosis grade (ρ = 29.203) according to a multivariate analysis (both P < 0.001). CAP could detect the different grades of steatosis: ≥S1 with AUROC of 0.81 at a cutoff of 224 dB/m, ≥S2 with AUROC of 0.90 at a cutoff of 236 dB/m and ≥S3 with AUROC of 0.97 at a cutoff of 285 dB/m. Furthermore, the LSM and fibrosis and activity grades on biopsy did not influence the CAP performance.
Conclusions

CAP presented excellent diagnostic performance for severe steatosis with high sensitivity and specificity in Chinese patients with CHB.

StephenW

消化系统疾病和科学
2015年1月，第60卷，第1期，第243-251
日期：2014年9月7日
控制衰减参数为脂肪肝无创性评估使用Fibroscan®：慢性乙型肝炎验证

    渝强米，
    齐于尸，
    梁煦，
    瑞方石，
    永岗刘，
    李平，
    封神
    纬路
    范建高


抽象
背景和目的

使用瞬时弹性成像（TE）控制衰减参数（CAP）的慢性丙型肝炎进行了验证，评价肝脏脂肪变性;然而，有限的数据可在慢性乙型肝炎（CHB）。因此，我们评估的准确性和CAP的功效为脂肪变性的慢性乙型肝炎的检测。
方法：

连续CHB患者接受肝活检和肝脏硬度测量（LSM）与使用M探头TE同时CAP决心。受试者工作特征曲线（AUROC）下的面积被用来评估CAP的诊断脂肪变性与活检相比的性能。
结果

共有340例患者：60％为男性，平均年龄为37岁;身体质量指数（BMI）为≥28公斤/平方米的受试者的14％;与脂肪变性等级的分布S058.2％，S134.2％，S25.0％和S32.6％。 CAP的中位数（范围）为218（100-400）分贝/米，和CAP与体重指数（ρ=3.622）和脂肪变性等级（ρ=29.203）相关，根据多变量分析（均P<0.001）。 CAP可以检测出不同档次的脂肪变性：用0.81 AUROC≥S1在224分贝/米截止，≥S20.90 AUROC在236分贝/米，≥S30.97 AUROC在285截止截止分贝/米。此外，在活检的LSM和纤维化和活性级别不影响该CAP性能。
结论

CAP呈现出色的性能诊断为严重的脂肪变性，具有灵敏度高，特异性的中国慢性乙肝患者。