弹性成像评价与慢性乙型肝炎患者肝纤维化血清学指标相结

StephenW

World J Gastroenterol. 2018 Oct 7;24(37):4272-4280. doi: 10.3748/wjg.v24.i37.4272.
Evaluation of elastography combined with serological indexes for hepatic fibrosis in patients with chronic hepatitis B.
Xu B1, Zhou NM2, Cao WT1, Li XJ3.
Author information

1
    Department of ultrasound, Fudan University affiliated Shanghai fifth people's hospital, Shanghai 200240, China.
2
    Department of ultrasound, Fudan University affiliated Shanghai fifth people's hospital, Shanghai 200240, China. [email protected].
3
    Department of pathology, Fudan University affiliated Shanghai fifth people's hospital, Shanghai 200240, China.

Abstract
AIM:

To investigate the value of ultrasound elastography combined with serological indexes in diagnosing liver fibrosis and assessing its severity.
METHODS:

A total of 338 chronic hepatitis B (CHB) patients were divided into a disease group (patients with hepatic fibrosis) and control group (subjects without hepatic fibrosis). The disease group was further divided into S1-S4 according to the degree of fibrosis. Independent risk factors for hepatic fibrosis were analyzed using multivariate logistic regression. The diagnostic values of hepatic fibrosis from different indicators were compared using receiver operating characteristic (ROC) curves. The combination of elastography and serological indexes was explored to assess the severity of hepatic fibrosis.
RESULTS:

The multivariate logistic regression analysis results revealed that shear wave velocity (SWV), hyaluronic acid (HA), type IV collagen (CIV) and aspartate aminotransferase-to-platelet ratio index (APRI) significantly affected the occurrence of hepatic fibrosis. The ROC curve revealed that the accuracy of the diagnosis of hepatic fibrosis for SWV and HA were 87.3% and 84.8%, respectively. The accuracy of SWV combined with HA was 88.9%. The multiple linear regression analysis revealed that SWV, aspartate aminotransferase (AST)/alanine aminotransferase (ALT), HA, CIV, APRI and fibrosis index based on the 4 factor (FIB-4) were screened as statistically significant independent factors. The established regression equation was: Fibrosis level = -4.046 + 1.024 × SWV + 1.170 × AST/ALT + 0.011 × HA + 0.020 × CIV + 0.719 × APRI + 0.379 × FIB-4.
CONCLUSION:

SWV combined with serological indexes can improve the accuracy of diagnosis for CHB hepatic fibrosis. Serum indexes can help diagnose the degree of hepatic fibrosis.
KEYWORDS:

Elastography; Hepatic fibrosis; Non-invasive diagnosis; Serology

PMID:
    30310260
PMCID:
    PMC6175765
DOI:
    10.3748/wjg.v24.i37.4272

StephenW

World J Gastroenterol。 2018年10月7日; 24（37）：4272-4280。 doi：10.3748 / wjg.v24.i37.4272。
弹性成像评价与慢性乙型肝炎患者肝纤维化血清学指标相结合
Xu B1，Zhou NM2，Cao WT1，Li XJ3。
作者信息

1
    复旦大学附属上海第五人民医院超声科，上海200240
2
    复旦大学附属上海第五人民医院超声科，上海200240 [email protected]。
3
    复旦大学附属上海市第五人民医院病理科，上海200240

抽象
目标：

探讨超声弹性成像结合血清学指标诊断肝纤维化及评估其严重程度的价值。
方法：

将338名慢性乙型肝炎（CHB）患者分为疾病组（肝纤维化患者）和对照组（无肝纤维化患者）。根据纤维化程度将疾病组进一步分为S1-S4。使用多变量逻辑回归分析了肝纤维化的独立危险因素。使用受试者工作特征（ROC）曲线比较来自不同指标的肝纤维化的诊断值。探讨弹性成像和血清学指标的组合以评估肝纤维化的严重程度。
结果：

多因素logistic回归分析结果显示，剪切波速（SWV），透明质酸（HA），IV型胶原（CIV）和天冬氨酸氨基转移酶与血小板比值指数（APRI）显着影响肝纤维化的发生。 ROC曲线显示SWV和HA的肝纤维化诊断准确率分别为87.3％和84.8％。 SWV联合HA的准确率为88.9％。多元线性回归分析显示，基于4因子（FIB-4）的SWV，天冬氨酸氨基转移酶（AST）/丙氨酸氨基转移酶（ALT），HA，CIV，APRI和纤维化指数被筛选为统计学上显着的独立因子。建立的回归方程为：纤维化水平= -4.046 + 1.024×SWV + 1.170×AST / ALT + 0.011×HA + 0.020×CIV + 0.719×APRI + 0.379×FIB-4。
结论：

SWV联合血清学指标可提高CHB肝纤维化诊断的准确性。血清指标可以帮助诊断肝纤维化程度。
关键词：

弹性;肝纤维化;无创诊断;血清学

结论：
    30310260
PMCID：
    PMC6175765
DOI：
    10.3748 / wjg.v24.i37.4272