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目的:探究在慢性丙型肝炎肝纤维化诊断中肝脏瞬时弹性超声成像(FS)的临床应用效果。方法:随机选择阳江市公共卫生医院2013年10月至2015年10月肝病门诊及住院的慢性丙型病毒性肝炎患者200例,运用FS法对患者的肝脏硬度值进行检测,同时对于患者的肝功能、血小板(PLT)水平和凝血指标等进行综合的检测,对患者进行肝脏穿刺活组织病理学检查,根据检测的结果绘制FS特性曲线,根据这条曲线可以计算患者在曲线下的面积(AUROC)和Stiffness值,并对其相关性做相应评估。结果:患者的肝脏Stiffness值随着纤维化程度的加重指标显著增加,比较数据,差异具有统计学意义(P<0.05)。以患者的Stiffness值8.05 kPa选为显著的肝纤维化的临界判断值,患者的敏感度60.5%,而特异度则是93.5%,阳性的预测值是95.02%,阴性的预测值是55.82%。而以患者的Stiffness值12.50 kPa选为显著的肝纤维化的临界判断值,患者的敏感度75.5%,特异度则是91.5%,阳性的预测值60.02%,而阴性的预测值是95.82%,患者的Stiffness值越高其检测的敏感性和特异性都有显著升高,差异具有统计学意义(P<0.05)。对患者的血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(Tbil)、白蛋白(Alb)、PLT等指标进行回归统计分析,发现在对患者的Stiffness值有明显影响,差异具有统计学意义(P<0.05)。结论:临床上采用FS对于慢性丙型肝炎肝纤维化患者的诊断效果准确率较高,对其肝纤维化以及肝硬化都具有较高的检出率。
Objective: To investigate the clinical application of liver transient elastography (FS) in the diagnosis of chronic hepatitis C with hepatic fibrosis. Methods: Two hundred patients with chronic hepatitis C were randomly selected from Yangjiang Public Health Hospital from October 2013 to October 2015. The patients with liver cirrhosis were tested by FS method. At the same time, Function, platelet (PLT) levels and coagulation parameters such as comprehensive detection, the patient liver biopsy biopsy, according to the results of the test results FS characteristic curve, according to this curve can be calculated under the curve of patients under the area (AUROC ) And Stiffness values, and their relevance assessed accordingly. Results: The value of liver Stiffness increased significantly with the degree of fibrosis. Compared with the data, the difference was statistically significant (P <0.05). The patients’ Stiffness value of 8.05 kPa was selected as the critical judgment value of liver fibrosis. The sensitivity was 60.5% and the specificity was 93.5%. The positive predictive value was 95.02% and the negative predictive value was 55.82%. The patients’ Stiffness value of 12.50 kPa was selected as the critical judgment value of hepatic fibrosis. The sensitivity, specificity and specificity were 75.5%, 91.5%, 60.02%, and 95.82%, respectively. The higher the Stiffness value of patients, the higher the sensitivity and specificity of the test, the difference was statistically significant (P <0.05). The regression analysis of the serum ALT, AST, Tbil, Alb and PLT showed that there was a significant effect on the Stiffness value of the patients, The difference was statistically significant (P <0.05). Conclusion: FS is clinically accurate in diagnosing chronic hepatitis C patients with liver fibrosis, and has a high detection rate of liver fibrosis and cirrhosis.