基於控制衰減參數值的診斷算法提高了慢性乙型肝炎患者肝

StephenW

Controlled attenuation parameter value-based diagnostic algorithm improves the accuracy of liver stiffness measurement in chronic hepatitis B patients
Yaoxin Fan  1 , Lin Wang  2 , Yang Ding  1 , Qiuju Sheng  1 , Chong Zhang  1 , Yanwei Li  1 , Chao Han  1 , Xiaoguang Dou  1
Affiliations
Affiliations

    1
    Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang Liaoning Province, China.
    2
    Department of Health Management, Shengjing Hospital of China Medical University, Shenyang Liaoning Province, China.

    PMID: 32836216 DOI: 10.18632/aging.103522

Abstract

Liver stiffness measurement (LSM) frequently overestimates the severity of liver fibrosis because of steatosis. However, the impact of the controlled attenuation parameter (CAP) on liver stiffness cutoff values remains unknown; CAP was used to quantify and diagnose the severity of hepatic steatosis. The study was conducted to determine the effect of CAP on liver stiffness cutoff values in chronic hepatitis B (CHB) patients. A retrospective cross-sectional study was performed in liver biopsy-proven CHB patients. The median LSM (kPa) in the elevated CAP group was higher than that in the normal CAP group at the same fibrosis stage. For S2-4, the area under the receiver operating characteristic (AUROC) curve of LSM was 0.78 and 0.72 in the normal and elevated CAP groups, respectively. When a cutoff value of 8.9 kPa was used, the diagnostic accuracy was 77.82% and 63.41% in the normal and elevated CAP groups, respectively. Compared with the alanine transaminase (ALT)-based LSM algorithm, the CAP-based LSM algorithm had a similar correct diagnosis rate (33.64% vs. 33.94%, respectively) but a lower misdiagnosis rate (16.97% vs. 20.30%, respectively). The new CAP-based LSM diagnostic algorithm will improve the diagnostic accuracy of liver fibrosis in CHB patients.

Keywords: chronic hepatitis B; controlled attenuation parameter; diagnostic algorithm; liver fibrosis measurement.

StephenW

基於控制衰減參數值的診斷算法提高了慢性乙型肝炎患者肝硬度測量的準確性
範耀新1，王林2，楊鼎1，邱秋生1，張沖1，李彥偉1，朝漢1，竇曉光1
隸屬關係
隸屬關係

    1個
    中國醫科大學附屬盛京醫院傳染病科，遼寧沉陽。
    2
    中國醫科大學附屬盛京醫院衛生管理系，遼寧沉陽。

    PMID：32836216 DOI：10.18632 / aging.103522

抽象

肝硬度測量（LSM）通常會因脂肪變性而高估肝纖維化的嚴重程度。但是，控制衰減參數（CAP）對肝硬度臨界值的影響仍然未知。 CAP用於量化和診斷肝脂肪變性的嚴重程度。進行這項研究以確定CAP對慢性乙型肝炎（CHB）患者肝硬度臨界值的影響。回顧性橫斷面研究在肝活檢證實的CHB患者中進行。在相同的纖維化階段，升高的CAP組的中位LSM（kPa）高於正常CAP組。對於S2-4，在正常和升高的CAP組中，LSM的接收器工作特性（AUROC）曲線下方的面積分別為0.78和0.72。當使用8.9 kPa的臨界值時，正常和升高的CAP組的診斷準確性分別為77.82％和63.41％。與基於丙氨酸轉氨酶（ALT）的LSM算法相比，基於CAP的LSM算法具有相似的正確診斷率（分別為33.64％和33.94％），但誤診率較低（分別為16.97％和20.30％）。 。新的基於CAP的LSM診斷算法將提高CHB患者肝纖維化的診斷準確性。

關鍵詞：慢性乙型肝炎；控制衰減參數；診斷算法；肝纖維化測量。