摘要
目的:研究腹部超声联合血清巨噬细胞集落刺激因子(M-CSF)水平检测对慢性乙型肝炎(CHB)肝纤维化程度的诊断价值。方法:选取2018年6月至2020年6月郑州大学第一附属医院收治的200例CHB患者,以病理诊断结果为金标准,将其分为轻度组(轻度纤维化,48例)、中度组(中度纤维化,82例)、重度组(重度纤维化,70例)。另选取同期于本院体检的健康受试者60人,设为正常组。比较4组超声结果、血清M-CSF水平;绘制受试者工作特征(ROC)曲线,分析血清M-CSF对CHB肝纤维化程度的诊断价值;同时采用绝对净重新分类指数(NRI)和综合判别改善指数(IDI)评价超声、血清M-CSF联合或单独的诊断效能。结果:正常组、轻度组、中度组、重度组肝门静脉内径、脾厚度、脾长度、脾静脉内径依次增大(P<0.05)。正常组[(241.65±30.28)ng/L]、轻度组[(307.65±32.24)ng/L]、中度组[(342.33±38.20)ng/L]、重度组[(380.54±42.61)ng/L]血清M-CSF水平依次升高,差异有统计学意义(P<0.001)。血清M-CSF诊断轻度、中度、重度纤维化的最佳截断点分别为302.41、336.15、354.27 ng/L。通过NRI及IDI分析,腹部超声、血清M-CSF联合较单独诊断轻度肝纤维化的效能高(P<0.001)。结论:腹部超声联合血清M-CSF水平诊断CHB肝纤维化程度的价值高于单独诊断。
Aim:To study the value of abdominal ultrasound combined with serum macrophage colony-stimulating factor(M-CSF)level in diagnosis of liver fibrosis for patients with chronic hepatitis B(CHB).Methods:A total 200 CHB patients admitted to our hospital from June 2018 to June 2020 were enrolled,the pathological diagnosis results were used as the gold standard,they were allocated into mild group(mild fibrosis,48 cases),moderate group(moderate fibrosis,82 cases),severe group(severe fibrosis,70 cases)according to the results of pathological diagnosis.In addition,60 healthy subjects who received physical examination in our hospital during the same period were selected as normal group.The ultrasound results and serum M-CSF levels of the 4 groups were compared.The diagnostic value of abdominal ultrasound combined with serum M-CSF on the degree of liver fibrosis was analyzed by ROC curve.At the same time,the net reclassification index(NRI)and the comprehensive discriminant improvement index(IDI)were used to evaluate the diagnostic efficacy of combination of ultrasound and serum M-CSF or alone.Results:The hepatic portal vein diameter,spleen thickness,spleen length,and splenic vein diameter in the normal,mild,moderate and severe groups were increased sequentially(P<0.05).The serum M-CSF levels in the normal,mild,moderate and severe groups were increased sequentially(P<0.05).The best cut-off points for the diagnosis of mild,moderate,and severe liver fibrosis by serum M-CSF were 302.41,336.15,and 354.27 ng/L,respectively.According to NRI and IDI analysis,combination of abdominal ultrasound and serum M-CSF were more effective than the single indicator in diagnosis of mild liver fibrosis(P<0.001).Conclusion:The value of abdominal ultrasound combined with serum M-CSF level in the diagnosis of liver fibrosis degree in patients with CHB is higher than that of single indicator.
作者
师秀雪
滑少华
陈菲
SHI Xiuxue;HUA Shaohua;CHEN Fei(Department of Ultrasonography,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Queen Mary School,Nanchang University,Nanchang 330000)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2021年第3期426-431,共6页
Journal of Zhengzhou University(Medical Sciences)
关键词
慢性乙型肝炎
肝纤维化
腹部超声
巨噬细胞集落刺激因子
chronic hepatitis B
liver fibrosis
abdominal ultrasound
macrophage colony-stimulating factor
