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瞬时弹性成像对不同年龄慢性乙型肝炎肝纤维化患儿的诊断价值

徐志强 董漪 王福川 王丽旻 闫建国 曹丽丽 王璞 李爱芹 钟彦伟 张敏

引用本文:
Citation:

瞬时弹性成像对不同年龄慢性乙型肝炎肝纤维化患儿的诊断价值

DOI: 10.3969/j.issn.1001-5256.2020.06.016
基金项目: 

首都临床特色应用研究课题(Z161100000516176); 

详细信息
  • 中图分类号: R725.1

Value of transient elastography in the diagnosis of liver fibrosis in chronic hepatitis B children of different ages

Research funding: 

 

  • 摘要:

    目的评估瞬时弹性成像FibroScan对0~18岁不同年龄段儿童慢性乙型肝炎(CHB)肝纤维化的诊断价值。方法选取解放军总医院第五医学中心2015年6月-2019年12月住院拟行抗病毒治疗的18岁以下的CHB患儿280例,其中学龄前儿童(≤6岁) 157例、学龄儿童(6~12岁) 74例、青少年(12~18岁) 49例。3组均行肝穿刺病理检查评估肝纤维化程度,按Matevia评分分为轻度(0≤F <2)、中度(2≤F <3)、重度(F≥3),同时应用FibroScan进行肝脏硬度值(LSM)测量。比较同一肝纤维化程度下3个年龄段儿童LSM的差异,评估年龄对LSM判定肝纤维化程度的影响。采用受试者工作特征曲线(ROC曲线)分析LSM诊断不同年龄段儿童乙型肝炎显著肝纤维化(F≥2)、进展期肝纤维化(F≥3)的界值。符合正态分布的计量资料多组间比较采用单因素方差分析;不符合正态分布的计量资料多组间比较采用Kruskal-Wallis H检验,进一步两两比较采用Wilcoxon检验。计数资料多组间比较采用χ2检验。相关性采用Spearman等级相关分析。结果轻...

     

  • [1] SALEH HA,ABU-RASHED AH. Liver biopsy remains the gold standard for evaluation of chronic hepatitis and fibrosis[J]. J Gastrointestin Liver Dis,2007,16(4):425-426.
    [2] van KATWYK S,COYLE D,COOPER C,et al. Transient elastography for the diagnosis of liver fibrosis:A systematic review of economic evaluations[J]. Liver Int,2017,37(6):851-861.
    [3] European Association for Study of Liver,Asociacion Latinoamericana para el Estudio del Higado. EASL-ALEH clinical practice guidelines:Non-invasive tests for evaluation of liver disease severity and prognosis[J]. J Hepatol,2015,63(1):237-264.
    [4] SINGH S,MUIR AJ,DIETERICH DT,et al. American gastroenterological association institute technical review on the role of elastography in chronic liver diseases[J]. Gastroenterology,2017,152(6):1544-1577.
    [5] Chinese Foundation for Hepatitis Prevention and Control,Chinese Society of Infectious Disease and Chinese Society of Hepatology, Chinese Medical Association; Liver Disease Committee of Chinese Research Hospital Association. Consensus on clinical application of transient elastography detecting liver fibrosis:A 2018 update[J]. Chin J Hepatol,2019,27(3):182-191.(in Chinese)中国肝炎防治基金会,中华医学会感染病学分会,中华医学会肝病学分会和中国研究型医院学会肝病专业委员会.瞬时弹性成像技术诊断肝纤维化专家共识(2018年更新版)[J].中华肝脏病杂志,2019,27(3):182-191.
    [6] Chinese Society of Hepatology and Chinese Society of Infectious Diseases,Chinese Medical Association. The guideline of prevention andtreatment for chronic hepatitis B:A 2015 update[J]. J Clin Hepatol,2015,31(12):1941-1960.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2015年更新版)[J].临床肝胆病杂志,2015,31(12):1941-1960.
    [7] MANNING DS,AFDHAL NH. Diagnosis and quantitation of fibrosis[J]. Gastroenterology,2008,134(6):1670-1681.
    [8] JONAS MM,BLOCK JM,HABER BA,et al. Treatment of children with chronic hepatitis B virus infection in the United States:Patient selection and therapeutic options[J]. Hepatology,2010,52(6):2192-2205.
    [9] TAPPER EB,LOK AS. Use of liver imaging and biopsy in clinical practice[J]. N Engl J Med,2017,377(8):756-768.
    [10] DEGOS F,PEREZ P,ROCHE B,et al. Diagnostic accuracy of FibroScan and comparison to liver fibrosis biomarkers in chronic viral hepatitis:A multicenter prospective study(the FIBROSTIC study)[J]. J Hepatol,2010,53(6):1013-1021.
    [11] CARDOSO AC,CARVALHO-FILHO RJ,STERN C,et al. Direct comparison of diagnostic performance of transient elastography in patients with chronic hepatitis B and chronic hepatitis C[J]. Liver Int,2012,32(4):612-621.
    [12] VIGANM,PAGGI S,LAMPERTICO P,et al. Dual cut-off transient elastography to assess liver fibrosis in chronic hepatitis B:A cohort study with internal validation[J]. Aliment Pharmacol Ther,2011,34(3):353-362.
    [13] ENGELMANN G,GEBHARDT C,WENNING D,et al. Feasibility study and control values of transient elastography in healthy children[J]. Eur J Pediatr,2012,171(2):353-360.
    [14] RUZMAN L,MIKOLASEVIC I,BARABA DEKANIC K,et al.Advances in diagnosis of chronic liver diseases in pediatric patients[J]. World J Pediatr,2018,14(6):541-547.
    [15] HWANG JY,YOON HM,KIM JR,et al. Diagnostic performance of transient elastography for liver fibrosis in children:A systematic review and meta-analysis[J]. AJR Am J Roentgenol,2018,211(5):w257-w266.
    [16] WANG L,ZHU M,CAO L,et al. Liver stiffness measurement can reflect the active liver necroinflammation in population with chronic liver disease:A real-world evidence study[J]. J Clin Transl Hepatol,2019,7(4):313-321.
    [17] KAMALI L,ADIBI A,EBRAHIMIAN S,et al. Diagnostic performance of ultrasonography in detecting fatty liver disease in comparison with fibroscan in people suspected of fatty liver[J]. Adv Biomed Res,2019,8:69.
    [18] TOKUHARA D,CHO Y,SHINTAKU H. Transient elastography-based liver stiffness age-dependently increases in children[J]. PLo S One,2016,11(11):e0166683.
    [19] GOLDSCHMIDT I,STRECKENBACH C,DINGEMANN C,et al.Application and limitations of transient liver elastography in children[J]. J Pediatr Gastroenterol Nutr,2013,57(1):109-113.
    [20] JIA J,HOU J,DING H,et al. Transient elastography compared to serum markers to predict liver fibrosis in a cohort of Chinese patients with chronic hepatitis B[J]. J Gastroenterol Hepatol,2015,30(4):756-762.
    [21] TESHALE E,LU M,RUPP LB,et al. APRI and FIB-4 are good predictors of the stage of liver fibrosis in chronic hepatitis B:The chronic hepatitis cohort study(CHe CS)[J]. J Viral Hepat,2014,21(12):917-920.
    [22] LUO WP,MA H,WANG Y. Advances in the application of transient elastography in noninvasive diagnosis of liver fibrosis[J]. J Clin Hepatol,2019,35(3):635-639.(in Chinese)罗文萍,马红,王宇.瞬时弹性成像在肝纤维化无创诊断中的应用进展[J].临床肝胆病杂志,2019,35(3):635-639.
    [23] ZHENG SQ,WANG QZ. Current status and prospects of research on noninvasive diagnosis of liver fibrosis[J]. J Clin Hepatol,2019,35(1):197-200.(in Chinese)郑少秋,王启之.无创肝纤维化诊断研究现状与前景[J].临床肝胆病杂志,2019,35(1):197-200.
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