摘要
目的:探讨不同血清丙氨酸转氨酶(ALT)浓度对于Fibroscan诊断肝纤维化期和肝硬化期的肝硬度准确性的影响。方法:根据血清ALT浓度分为三组:A组ALT<l×ULN(正常值上限)、B组l×ULN<ALT<2×ULN、C组ALT≥2×ULN。同时对三组病人采用FibroScan计算不同肝纤维化期和肝硬化期ROC曲线下面积,再进行统计学分析。结果:A组、B组、C组中肝纤维化期和肝硬化期的肝硬度值的中位数值分别为(12.249kPa和22.41kPa)、(10.67kPa和21.78kPa)、(9.05kPa和20.04kPa),并且三组中肝纤维化期与肝硬化期间的差异均具有统计学意义(ZA=2.770,PA=0.006;ZB=2.656,PB=0.008;ZC=2.486,PC=0.013),说明随着肝纤维化发展为肝硬化,三组的肝硬度值呈逐渐上升趋势。在肝纤维化期,A组、B组和C组AUROC分别为0.927、0.941和0.639;敏感度分别为91.0%、88.5%和45.9%;准确度分别为91.2%、87.8%和64.9%,可见C组硬度诊断的准确性随ALT升高而降低。在肝硬化期,A组、B组和C组的AUROC分别为0.948%、0.937%和0.951%;敏感度分别为94.1%、100%和99.7%,准确度分别为88.1%、94.5%和92.9%,可见三组的硬度诊断的准确性受血清ALT水平的影响不大。结论:Fibroscan仪器是诊断肝纤维化的可靠手段。肝纤维化期时,FibmScan诊断的准确性可受ALT浓度的影响,但肝硬化期时,FibmScan诊断的准确性受ALT浓度的影响不大。
Objective：To explore the accuracy of Fibroscan for diagnosis hepatic hardness in hepatic fibrosis and hepatic cirrhosis influenced by different levels of serum alanine transaminase（ALT）.Methods：According to the levels of serum ALT,they were divided into three groups：Group A ALTl×ULN（upper limit of normal value）,Group B l×ULNALT2×ULN,and Group C ALT≥2× ULN.The Area under the ROC curve in hepatic fibrosis and hepatic cirrhosis in the three groups were calculated simultaneously using FibroScan.Then,they were statistically analyzed.Results：Median value of hepatic hardness value in hepatic fibrosis and hepatic cirrhosis of Group A,Group B,Group C respectively were（12.249 kPa and 2 2.41 kPa）,（10.67 kPa and 21.78 kPa）,（9.05 kPa and 20.04 kPa）.And the differences in hepatic fibrosis and hepatic cirrhosis of Group A,Group B,Group C were statistically significant（ZA=2.770,PA=0.006;ZB=2.656,PB=0.008;ZC=2.486,PC=0.013）.With hepatic fibrosis developing into hepatic cirrhosis,hepatic hardness values of the three groups were gradually increased.In hepatic fibrosis,AUROC of Group A,Group B,Group C respectively were 0.927,0.941 and 0.639;sensitivity respectively were 91.0%,88.5% and 45.9%;and accuracy respectively were 91.2%,87.8% and 64.9%.It demonstrated that the accuracy of diagnosis of hepatic hardness of Group C reduced with ALT increasing.In hepatic cirrhosis,AUROC of Group A,Group B,Group C respectively were 0.948,0.937,0.951;sensitivity respectively were 94.1%,100%,99.7%;and accuracy respectively were 88.1%,94.5%,92.9%.It demonstrated that levels of serum ALT did not influence the accuracy of diagnosis of hepatic hardness of Group C.Conclusions：Fibroscan instrument is a reliable means for diagnosis of hepatic fibrosis.It demonstrates that the accuracy of diagnosis of hepatic hardness of Group C reduce with ALT increasing in hepatic fibrosis,but,in hepatic cirrhosis,levels of serum ALT do not influence the accuracy of diagnosis with Fibroscan.
出处
《现代生物医学进展》
CAS
2012年第36期7040-7043,共4页
Progress in Modern Biomedicine
