降低肝脏弹性临界值对慢性丙型肝炎患者获得持续病毒学应答后肝纤维化的评估价值
目的 拟在获得SVR后随访的慢性丙型肝炎患者中，通过肝穿刺病理进一步验证无创肝纤维化诊断方法对于肝纤维化的预测能力。 方法 本研究为前瞻性队列研究，所有患者为2015年10月—2017年12月首都医科大学附属北京佑安医院就诊的慢性丙型肝炎患者，在获得持续病毒学应答(SVR)后进行规律随访并完成肝穿刺病理检查，用病理验证无创肝纤维化方法的诊断效能。根据受试者工作特征曲线(ROC曲线)评价LSM、APRI和FIB-4对肝纤维化的诊断能力。应用STATA及R语言，采用Delong法比较ROC曲线下面积(AUC)。 结果 共96例患者成功入组。获得SVR后LSM较基线显著降低，LSM诊断SVR后肝硬化...
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| Published in | Linchuang gandanbing zazhi Vol. 37; no. 12; pp. 2808 - 2812 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
Changchun
Journal of Clinical Hepatology
01.01.2021
首都医科大学附属北京佑安医院肝病三科,北京100069 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1001-5256 2097-3497 |
| DOI | 10.3969/j.issn.1001-5256.2021.12.016 |
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| Abstract | 目的 拟在获得SVR后随访的慢性丙型肝炎患者中，通过肝穿刺病理进一步验证无创肝纤维化诊断方法对于肝纤维化的预测能力。 方法 本研究为前瞻性队列研究，所有患者为2015年10月—2017年12月首都医科大学附属北京佑安医院就诊的慢性丙型肝炎患者，在获得持续病毒学应答(SVR)后进行规律随访并完成肝穿刺病理检查，用病理验证无创肝纤维化方法的诊断效能。根据受试者工作特征曲线(ROC曲线)评价LSM、APRI和FIB-4对肝纤维化的诊断能力。应用STATA及R语言，采用Delong法比较ROC曲线下面积(AUC)。 结果 共96例患者成功入组。获得SVR后LSM较基线显著降低，LSM诊断SVR后肝硬化的AUC为0.89，显著高于APRI (AUC=0.67)及FIB-4(AUC=0.69)(P值均＜0.05)。其中LSM最佳cut off值为7.95 kPa，根据最佳特异度，LSM＞9.15 kPa，可考虑诊断肝硬化，阳性似然比为5.91；LSM＜6.85 kPa排除进展期肝纤维化，阴性预测值为0.98。随访时间和抗病毒方案对LSM的诊断能力没有影响。 结论 慢性丙型肝炎患者获得SVR后需降低肝脏弹性临界值来评估肝纤维化。 |
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| AbstractList | 目的 拟在获得SVR后随访的慢性丙型肝炎患者中，通过肝穿刺病理进一步验证无创肝纤维化诊断方法对于肝纤维化的预测能力。 方法 本研究为前瞻性队列研究，所有患者为2015年10月—2017年12月首都医科大学附属北京佑安医院就诊的慢性丙型肝炎患者，在获得持续病毒学应答(SVR)后进行规律随访并完成肝穿刺病理检查，用病理验证无创肝纤维化方法的诊断效能。根据受试者工作特征曲线(ROC曲线)评价LSM、APRI和FIB-4对肝纤维化的诊断能力。应用STATA及R语言，采用Delong法比较ROC曲线下面积(AUC)。 结果 共96例患者成功入组。获得SVR后LSM较基线显著降低，LSM诊断SVR后肝硬化的AUC为0.89，显著高于APRI (AUC=0.67)及FIB-4(AUC=0.69)(P值均＜0.05)。其中LSM最佳cut off值为7.95 kPa，根据最佳特异度，LSM＞9.15 kPa，可考虑诊断肝硬化，阳性似然比为5.91；LSM＜6.85 kPa排除进展期肝纤维化，阴性预测值为0.98。随访时间和抗病毒方案对LSM的诊断能力没有影响。 结论 慢性丙型肝炎患者获得SVR后需降低肝脏弹性临界值来评估肝纤维化。 R512.63; 目的 拟在获得SVR后随访的慢性丙型肝炎患者中,通过肝穿刺病理进一步验证无创肝纤维化诊断方法对于肝纤维化的预测能力.方法 本研究为前瞻性队列研究,所有患者为2015年10月—2017年12月首都医科大学附属北京佑安医院就诊的慢性丙型肝炎患者,在获得持续病毒学应答(SVR)后进行规律随访并完成肝穿刺病理检查,用病理验证无创肝纤维化方法的诊断效能.根据受试者工作特征曲线(ROC曲线)评价LSM、APRI和FIB-4对肝纤维化的诊断能力.应用STATA及R语言,采用De-long法比较ROC曲线下面积(AUC).结果 共96例患者成功入组.获得SVR后LSM较基线显著降低,LSM诊断SVR后肝硬化的AUC为0.89,显著高于APRI(AUC=0.67)及FIB-4(AUC=0.69)(P值均<0.05).其中LSM最佳cut off值为7.95 kPa,根据最佳特异度,LSM>9.15 kPa,可考虑诊断肝硬化,阳性似然比为5.91;LSM<6.85 kPa排除进展期肝纤维化,阴性预测值为0.98.随访时间和抗病毒方案对LSM的诊断能力没有影响.结论 慢性丙型肝炎患者获得SVR后需降低肝脏弹性临界值来评估肝纤维化. |
| Author | 宋静静 柳雅立 仇丽霞 梁珊 张晶 |
| AuthorAffiliation | 首都医科大学附属北京佑安医院肝病三科,北京100069 |
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| Author_FL | QIU Lixia LIANG Shan SONG Jingjing LIU Yali ZHANG Jing |
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| Copyright | 2021. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Copyright © Wanfang Data Co. Ltd. All Rights Reserved. |
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| Keywords | 丙型肝炎,慢性;肝硬化;弹性成像技术;持续病毒学应答 |
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| Snippet | 目的 拟在获得SVR后随访的慢性丙型肝炎患者中，通过肝穿刺病理进一步验证无创肝纤维化诊断方法对于肝纤维化的预测能力。 方法... R512.63; 目的 拟在获得SVR后随访的慢性丙型肝炎患者中,通过肝穿刺病理进一步验证无创肝纤维化诊断方法对于肝纤维化的预测能力.方法... |
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| SubjectTerms | Biopsy Hepatitis C Liver cirrhosis |
| Title | 降低肝脏弹性临界值对慢性丙型肝炎患者获得持续病毒学应答后肝纤维化的评估价值 |
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