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ARFI、Forns指数、FIB-4和APRI无创诊断慢性乙型病毒性肝炎肝纤维化的研究
作者:刘京1 2 刘映霞1  董常峰1 姚思敏1 李莎茜1 袁静1 陈川铁2 赵美芬2 林益敏1 彭忠田2 
单位:1.深圳巿第三人民医院 感染科 感染性疾病国家重点学科 广东 深圳 518112 2.南华大学第一临床学院 感染科 湖南 衡阳 421001 
关键词:无创诊断 慢性乙型病毒性肝炎 肝纤维化 
分类号:
出版年,卷(期):页码:2014,6(1):18-21
摘要:

摘要:目的 声辐射力脉冲成像技术(ARFI)及血清学诊断模型(Forns指数、FIB-4、APRI)对慢性乙型病毒性肝炎肝纤维化评估的价值。方法 111例确诊为慢性乙型病毒性肝炎患者,根据肝组织活检病理分期结果分组:无明显肝纤维化组(S0、S1)40例,明显肝纤维化组(≥ S2)48例、早期肝硬化组(S4)23例。每例患者同期进行ARFI、Forns指数、FIB-4、APRI的评估。比较无创诊断模型与肝脏病理的相关性,并根据受试者工作特征曲线(ROC)分析无创诊断模型对肝纤维化的诊断价值。结果 ARFI、Forns指数、FIB-4、APRI 4种无创诊断方法与肝组织活检具有良好的一致性,其皮尔逊相关系数(Pearson correlation coefficient)分别为0.882 、0.639、0.589、0.418。明显肝纤维化组(≥ S2)及早期肝硬化组,ARFI的诊断价值均优于FIB-4(Z = 2.882,P = 0.004;Z = 3.215,P = 0.001)、APRI(Z = 4.850,P < 0.001;Z = 3.198,P = 0.001)、Forns指数(Z = 2.182,P = 0.029;Z = 2.798,P = 0.005)。结论 ARFI对明显肝纤维化及早期肝硬化的诊断具有较高的价值,值得推广。

Abstract: Objective To assessment the value of acoustic radiation force impulse (ARFI) and serological diagnosis model (Forns index, FIB-4, APRI) to liver fibrosis of chronic hepatic B. Methods Total of 111 patient confirmed as CHB, divided into groups according to the result of the liver biopsy: no significant liver fibrosis group (S0, S1) 40 cases, significantly fibrosis group (≥ S2) 48 cases, early cirrhosis group (S4) 23 cases. During the same period, each patient with the assessment of ARFI, Forns index, Fib-4 and APRI. Compared the correlation of noninvasive diagnosis model and liver biopsy. Moreover, analysis the diagnostic value of noninvasive liver fibrosis model to the liver fibrosis according to the receiver-operating characteristic curve. Results ARFI, Forns index, FIB-4, APRI, the four kinds of noninvasive diagnostic method has a good consistency with liver biopsy, and their Pearson correlation coefficient were 0.882, 0.639, 0.589, 0.418. The assessment value of ARFI to significantly fibrosis group (≥ S2) was superior to FIB-4 (Z = 2.882, P = 0.004; Z = 3.215, P = 0.001), APRI (Z = 4.850, P < 0.001; Z = 3.198, P = 0.001), Forns index (Z = 2.182, P = 0.029; Z = 2.798, P = 0.005). Conclusions The assessment value to significantly fibrosis and early cirrhosis of ARFI is higher than others and worthy of promotion.

基金项目:
深圳市医学重点专科基金(201161),深圳市科技创新委技术开发项目基金(CXZZ20130322170220544)
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