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目的评价肝脏瞬时弹性成像(FibroScan)及血清肝纤维化4项[透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)和血清Ⅲ型前胶原(PCⅢ)]对肝移植患者发生明显肝纤维化(F>2)的诊断价值。方法选择2013年2月28日一2014年7月8日在本院治疗的行经皮肝脏穿刺活体组织检查的肝移植和非肝移植慢性肝病患者各40例,进行FibroScan检查以及血清肝纤维化4项检测。将肝脏硬度测定(liver stiffness measurement,LSM)值和血清肝纤维化4项结果与病理检查的肝纤维化程度进行相关性分析,用受试者工作特征曲线(receiver-operating characteristic curve,ROC曲线)分析和评估LSM值和血清肝纤维化4项对肝移植患者明显肝纤维化的诊断价值。结果肝移植患者HA和LSM值与肝纤维化评分呈正相关,r_s分别为0.689和0.782。HA和LSM值诊断肝移植患者明显纤维化的ROC曲线下面积分别为0.789和0.943。明显肝纤维化患者中,肝移植者的LSM值高于非肝移植患者(P<0.05);无明显肝纤维化(F≤2)的患者中,肝移植者Ⅳ-C和PCⅢ低于非肝移植患者(P均<0.05)。结论 LSM值和血清HA与肝移植患者的肝纤维化评分呈正相关,它们对肝移植患者的明显肝纤维化具有一定的诊断价值。
Objective To evaluate the effects of FibroScan and serum hepatic fibrosis on the expression of HA, LN, Ⅳ-C and PCⅢ in liver. Liver transplantation patients with significant liver fibrosis (F> 2) diagnostic value. Methods Forty patients with chronic liver disease who underwent percutaneous liver biopsy in our hospital from February 28, 2013 to July 8, 2014 were enrolled in our study. FibroScan and serum hepatic fibrosis 4 Item detection. The liver stiffness measurement (LSM) values and serum liver fibrosis were compared between the four results and the pathological examination of liver fibrosis, using the receiver operating characteristic curve (receiver-operating characteristic curve, ROC curve) To analyze and evaluate the value of LSM and serum liver fibrosis in the diagnosis of liver fibrosis in patients with liver transplantation. Results The values of HA and LSM in liver transplantation patients were positively correlated with the scores of liver fibrosis, r_s were 0.689 and 0.782 respectively. The area under the ROC curve of HA and LSM values for diagnosing liver fibrosis was 0.789 and 0.943, respectively. In patients with liver fibrosis, the LSM of liver transplant recipients was significantly higher than that of non-liver transplant recipients (P <0.05). In patients with no obvious fibrosis (F≤2), the liver transplant recipients had lower levels of Ⅳ-C and PCⅢ Liver transplantation patients (all P <0.05). Conclusions There is a positive correlation between LSM value and serum HA in patients with liver transplantation and their liver fibrosis score. They have certain diagnostic value on liver fibrosis in patients undergoing liver transplantation.