摘要
目的:探讨肝脏剪切波弹性成像联合基于4因子的纤维化指数(FIB-4)、血清高尔基体蛋白73(GP73)、壳多糖酶3样蛋白1(CHI3L1)对慢性乙型肝炎(CHB)患者肝纤维化的诊断价值.方法:选择2020年6月至2022年12月解放军总医院第五医学中心收治的186例CHB患者,基于肝纤维分期将患者分为显著性肝纤维化组(116例)和非显著性肝纤维化组(70例).所有CHB患者接受肝脏剪切波弹性成像检查获得肝脏剪切波弹性成像参数,评估FIB-4指数,检测血清GP73、CHI3L1水平.受试者工作特征(ROC)曲线分析肝脏剪切波弹性成像参数联合FIB-4指数、血清GP73、CHI3L1诊断CHB患者显著性肝纤维化的价值.结果:显著性肝纤维化组Max、Mean、Min、FIB-4指数、血清GP73、CHI3L1水平高于非显著性肝纤维化组(P＜0.05).Max、Mean、Min、FIB-4、GP73、CHI3L1诊断CHB患者显著性肝纤维化的曲线下面积为0.801、0.773、0.708、0.795、0.788、0.783,联合诊断曲线下面积为0.905,高于单独诊断.结论:CHB显著性肝纤维化患者Max、Mean、Min、FIB-4指数、血清GP73、CHI3L1水平均升高,肝脏剪切波弹性成像参数联合FIB-4指数、血清GP73、CHI3L1可提高诊断CHB患者显著性肝纤维化的效能.
Abstract
Objective:To investigate the diagnostic value of liver shear wave elastography combined with fibrosis index based on factor 4(FIB-4),serum Golgi protein 73(GP73)and chitinase 3-like protein 1(CHI3L1)for liver fibrosis in patients with chronic hepati-tis B(CHB).Methods:186 CHB patients admitted to The Fifth Medical Center of People's Liberation Army General Hospital from June 2020 to December 2022 were selected,and patients were divided into significant liver fibrosis group(116 cases)and non-significant liver fibrosis group(70 cases)based on liver fibrosis stage.All CHB patients underwent liver shear wave elastography to obtain liver shear wave elastography parameters,evaluate FIB-4 index,and detect serum GP73 and CHI3L1 levels.The value of liver shear wave elastogra-phy parameters combine with FIB-4 index,serum GP73 and CHI3L1 in diagnosing significant liver fibrosis in CHB patients were ana-lyzed by receiver operating characteristic(ROC)curve.Results:Max,Mean,Min,FIB-4 index,serum GP73 and CHI3L1 levels in signif-icant liver fibrosis group were higher than those in non-significant liver fibrosis group(P＜0.05).The area under the curve of Max,Mean,Min,FIB-4,GP73 and CHI3L1 in the diagnosis of significant liver fibrosis in CHB patients was 0.801,0.773,0.708,0.795,0.788 and 0.783 respectively,the area under the curve of combined diagnosis was 0.905,which was higher than that of single diagnosis.Conclu-sion:The levels of Max,Mean,Min,FIB-4 index,serum GP73 and CHI3L1 in patients with significant liver fibrosis in CHB are increase,liver shear wave elastography parameters combined with FIB-4 index,serum GP73 and CHI3L1 can improve the efficacy in diagnosing significant liver fibrosis in CHB patients.
基金项目
联勤保障部队装备军内科研项目(LB20211A010026)
NETL
NSTL
万方数据