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目的通过在选定患者中进行13C-美沙西汀呼气试验(13C-MBT),进而评估13C-MBT在慢性肝病患者肝纤维化与硬化分期中的作用。方法选取40例慢性肝病患者进行13C-MBT,通过收集呼气样本,采用非色散同位素选择性红外光谱仪(IRIS)测定13CO2/12CO2同位素比值。以敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和UCB分析确定13C-MBT在慢性肝病分期中的诊断价值。结果 MBT评估肝纤维化、肝硬化、Child-Pugh A级、B级和C级的敏感性与阳性预测值分别为66%和55%,90%和90%,68%和43%,42%和41%,50%和76%。肝纤维化的UCB为0.60,肝硬化UCB为0.94。结论13C-MBT对于肝纤维化无预测价值,但可准确评估进展期肝硬化。
Objective To evaluate the role of 13C-MBT in liver fibrosis and cirrhosis staging in patients with chronic liver disease by 13C-methacetin breath test (13C-MBT) in selected patients. Methods Totally 40 patients with chronic liver disease were selected for 13C-MBT. By collecting breath samples, the 13CO2 / 12CO2 isotope ratio was determined by non-dispersive isotope selective infrared spectroscopy (IRIS). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and UCB analysis were used to determine the diagnostic value of 13C-MBT in the staging of chronic liver disease. Results The sensitivity and positive predictive value of MBT for liver fibrosis, liver cirrhosis, Child-Pugh class A, B and C were 66% and 55%, 90% and 90%, 68% and 43%, 42% And 41%, 50% and 76% respectively. UCB for liver fibrosis was 0.60 and UCB for cirrhosis was 0.94. Conclusions 13C-MBT has no predictive value for hepatic fibrosis, but can accurately assess advanced cirrhosis.