FibroTouch联合ALB、ALP、AFU对肝硬化的诊断价值及预后评价-现代医学

FibroTouch联合ALB、ALP、AFU对肝硬化的诊断价值及预后评价

单位：贵港市人民医院感染性疾病科, 贵州贵港 537100

分类号：R575.2;R445.1

出版年·卷·期（页码）：2020·39·第四期（484-487）

摘要：

目的：评价瞬时弹性成像技术（FibroTouch）联合血清白蛋白（ALB）、α-L-岩藻糖苷酶（AFU）和碱性磷酸酶（ALP）对肝硬化的诊断价值及预后评价。方法：2017年1~6月本院诊治的肝硬化患者375例，使用FibroTouch测量其肝脏硬度值（LSM），检测患者血清ALB、ALP、AFU水平。比较不同Child-Pugh分级患者LSM及ALB、ALP、AFU水平差异。采用Logistic回归分析进行风险预测，应用受试者工作特征曲线（ROC）评价诊断试验的效能。结果：随着肝硬化患者疾病程度的加重，血清AFU和ALP含量显著升高，LSM显著增大，ALB水平显著降低（P<0.05）。通过直线相关分析结果发现，肝硬化患者LSM、AFU和ALP水平与疾病严重程度呈正相关（P<0.05）；ALB水平与疾病严重程度呈负相关（P<0.05）。经ROC分析可知，LSM单独预测肝硬化患者的ROC曲线下面积（AUC）为0.886（95% CI为0.79~0.94，P<0.001）。并联试验灵敏度为92.00%，串联试验特异度为95.00%，显著大于各单项生物学标志物检测（P<0.05）。结论：FibroTouch联合ALB、ALP、AFU对肝硬化的诊断及预测价值较高，值得临床推广研究。

Objective: To evaluate the diagnostic value and prognosis evaluationof FibroTouch combined with serum albumin (ALB), α-L-fucosidase (AFU) and alkaline phosphatase (ALP) in patients with cirrhosis. Methods: From January to June 2017, the liver stiffness measurement(LSM) of 375 patients with liver cirrhosiswere detectedwith FibroTouch. The serum levels of ALB, ALP and AFU were measured. The differences in LSM, ALB, ALP, and AFU levels were compared between patients with different Child-Pugh grades. Risk prediction was performed byusing Logistic regression analysis, and the receiver operating characteristic curve (ROC) was used to evaluate the efficacy of the diagnostic test. Results: With the severity of disease in patients with cirrhosis, serum AFU and ALP levels increased significantly, LSMincreased significantly, and serum ALB decreased significantly (P<0.05). The results of linear correlation analysis showed that there was a significant positive correlation between LSM, AFU and ALP levels in patients with liver cirrhosis and the severity of disease(P<0.05). The correlation of ALB level withdisease severity was significantly negative(P<0.05). According to ROC analysis, FibroTouch (LSM value) alone predicted AUC of 0.886 (95% CI:0.79-0.94, P<0.001).The parallel test sensitivity was 92.00%, and the tandem test specificity (used) was 95.00%, which was significantly greater than the individual biomarker test (P<0.05).Conclusion: FibroTouch combined with ALB, ALP and AFU is of high value in the diagnosis and prediction of patients with liver cirrhosis. It is worthy of clinical research.

参考文献：

[1] 中华医学会肝病学分会.肝硬化诊治指南[J].现代医药卫生,2020,36(2):320,插1-插18.
[2] 高成广,谢峰,冯亚东.生长抑素联合泮托拉唑治疗肝硬化合并上消化道出血的效果观察[J].临床肝胆病杂志,2016,32(2):284-287.
[3] POYNARD T,PHAM T,PERAZZO H,et al.Real-time shear wave versus transient elastography for predicting fibrosis:applicabiliy,and impact of inflammation and steatosis.a non-invasive comparison[J].PLoS One,2016,11(10):e0163276.
[4] 赵子龙,康海燕,张志,等.阿德福韦酯联合拉米夫定与恩替卡韦单药治疗乙肝肝硬化疗效比较[J].现代中西医结合杂志,2016,25(33):3716-3718.
[5] 刘斌,方正亚,孟冬梅,等.肝硬化并发症治疗及预防研究进展[J].中华实用诊断与治疗杂志,2016,30(12):1152-1155.
[6] 胡娜,欧晓娟.FibroTouch评价脾脏硬度与肝硬化门静脉高压参数的相关性分析[J].中华临床医师杂志(电子版),2016,10(04):468-470.
[7] KIN W R,BERG T,ASSELAHT,et al.Evaluation of APRI and FIB4 scoring systems for non- invasive as assessment of hepatic fibrosis in chronic hepatitis B patients[J].J Hepatol,2016,64(2):773-780.
[8] 中华医学会肝病学分会，中华医学会消化病学分会，中华医学会感染病学分会.原发性胆汁性肝硬化(又名原发性胆汁性胆管炎)诊断和治疗共识(2015)[J].肝脏,2015,20(12):960-968.
[9] European Association for Study of Liver,Association Latinoamericana para el Estudio del Hiqado.EASL- ALEH clinical practice guideline:non-invasive tests for evaluation of liver disease severity an prognosis[J].J Hepatol,2015,63:237- 264.
[10] 明芳,秦刚,李民,等.FibroTouch在慢性肝病中临床的应用及与多参数模型的比较[J].重庆医学,2017,46(36):5101-5103.
[11] MARCELLIN P,ZIOL M,BEDOSSA P,et al.Non-invasive assessment of liver fibrosiss by stiffenss measurement in patients with chronic hepatitis B[J].Liver Int,2009,29(2):242-247.
[12] SHIBA G,LBRAHIM A,HELMY A,et al.Asian- Pacific Association for the Study of the Liver(APASL) consensus guideline on incasive and non- invasive assessment of hepatic fibrosis:a 2016 update[J].Hepatol Int,2017,11(2):1-30.
[13] 文关良.肝炎肝硬化患者血清CHE、ALB、CHO水平检测在肝功能评估中的临床应用价值[J].检验医学与临床,2017,14(18):2741-2742.
[14] 郝俊.酒精性肝硬化与肝炎后肝硬化的临床对比分析[J].中国医药指南,2016,14(3):132-133.
[15] 朱月萍,朱传武,钱峰,等.慢性乙肝4项临床指标联合检测在早期肝硬化快速筛查中的应用[J].东南大学学报(医学版),2017,36(5):833-837.
[16] 王芳印.肝脏疾病血清AFU与ALT、AST、GGT相关性研究[J].内蒙古中医药,2017,36(5):112.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录