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目的探讨肝脏瞬时弹性成像系统(FS)对慢性乙型肝炎肝脏纤维化的诊断意义。方法随机选取本院162例慢性乙型肝炎患者分别行FS值检测,受试者同期行肝穿刺活检。以肝活检的不同分级结果为判断界点构建FS的ROC曲线,计算曲线下面积(AUC)、阳性和阴性结果的临界值(cut-off值),评价FS对慢性乙型肝炎肝脏纤维化的诊断意义。结果 FS对显著纤维化(S2-S4)、严重纤维化(S3-S4)、早期肝硬化(S4)的AUC值分别为0.81、0.88、0.90,cut-off值分别为7.3、9.7、17.5 KPa;随着肝功能受损程度的加重,胆红素、转氨酶的升高对FS值的影响差异有统计学意义。结论 Fibroscan对慢性乙型肝炎肝脏纤维化的诊断分析有较高的临床价值,对肝硬化、严重纤维化、显著纤维化(S≥2)的诊断价值优于轻度肝纤维化(S<2)。
Objective To investigate the diagnostic value of liver transient elastography (FS) in the diagnosis of hepatic fibrosis in chronic hepatitis B patients. Methods A total of 162 patients with chronic hepatitis B in our hospital were randomly selected for FS value test. The subjects underwent liver biopsy in the same period. The grading results of liver biopsy were used to determine the ROC curve of FS. The area under the curve (AUC) and the cut-off values of positive and negative results were calculated, and the effect of FS on liver fibrosis of chronic hepatitis B Diagnostic significance. Results The AUC values of FS for significant fibrosis (S2-S4), severe fibrosis (S3-S4) and early cirrhosis (S4) were 0.81,0.88,0.90 and cut-off values were 7.3, 9.7 and 17.5 KPa ; With the aggravation of the degree of liver damage, bilirubin and aminotransferase increased the impact of FS value difference was statistically significant. Conclusion Fibroscan has high clinical value in the diagnosis of liver fibrosis in patients with chronic hepatitis B. The diagnostic value of Fibroscan for cirrhosis, severe fibrosis and significant fibrosis (S≥2) is better than that of mild hepatic fibrosis (S <2 ).