FibroTouch及FibroScan实施受控衰减参数评价肝细胞脂肪变与肝脏病理比较分析

doi:10.7504/nk2014050402

摘要/Abstract

摘要：

目的评价瞬时弹性超声诊断仪FibroTouch、FibroScan实施受控衰减参数(CAP)无创定量诊断脂肪肝与肝脏穿刺病理结果的对比及相关分析。方法对2013年7-10月在杭州师范大学附属医院对病理确诊的非酒精性脂肪性肝病(NAFLD)患者及慢性乙型肝炎患者(CHB)应用FibroTouch、FibroScan-502机型测定肝脏脂肪含量(CAP值)。结果 41例CHB患者与20例NAFLD患者同时接受FibroTouch、FibroScan检查，测定的CAP与患者体质量指数(BMI，r分别为0.42，0.61；P分别为0.02，0.000)及肝细胞脂肪变呈正相关(r分别为0.54，0.56；P均<0.001)；33例病理诊断肝细胞脂肪变>5%的患者FibroTouch与FibroScan测定的CAP值均显著高于28例无脂肪变的CAP值［FibroTouch：(252.18±41.23)dB/m比(220.68±54.75)dB/m，P=0.04；FibroScan：(291.61±56.80)dB/m比(215.75±45.11)dB/m，P=0.000］；FibroScan测定肝细胞脂肪变<30%患者的CAP值、肝细胞脂肪变30%~60%患者的CAP值、>60%脂肪变组的CAP值间存在差异(F=6.82，P=0.004)，且肝细胞脂肪变<30%患者的CAP值低于>60%脂肪变组的CAP值［(258.73±52.54)dB/m比(327.42±49.08)dB/m，P=0.04］。但FibroTouch对上述3组患者测定的CAP值间差异无统计学意义(F=2.30，P=0.12)。结论 FibroTouch与FibroScan测定的CAP值均能评价肝细胞脂肪变，CAP值的高低与患者的BMI大小、肝病理脂肪变严重程度呈正相关。FibroScan测定的CAP值能区分轻度与重度的脂肪变，而FibroTouch测定的CAP值不能区分，可能与本组实验病例过少有关，有待进一步研究。

关键词: 瞬时弹性超声诊断仪, 受控衰减参数, 病理, 肝细胞脂肪变

Abstract:

Abstract：Objective To compare the controlled attenuation parameters (CAP) measurement of liver steatosis using FibroTouch and FibroScan. Methods Patients with non-alcohol fatty liver disease (NAFLD) and chronic hepatitis B (CHB) were included from July to October 2013 and liver biopsy was completed on these patients.They were examined to collect the CAP values by FibroTouch and FibroScan-502 respectively.Results A total of 41 patients with CHB and 20 patients with NAFLD were recruited.CAP values of FibroScan and FibroTouch are positively correlated with BMI (r=0.42，0.61；P=0.02，0.000) and degree of liver steatosis (r=0.54，0.56；P=0.001，0.001).CAP values of 33 patients with >5% fat degeneration of liver cells were significantly higher than those of patients with no fat degeneration (FibroTouch［252.18±41.23］dB/m vs ［220.68±54.75］dB/m，P=0.04；FibroScan［291.61±56.80］B/m vs ［215.75±45.11］dB/m，P=0.000).CAP values of patients with liver steatosis <30% were significantly lower than those of patients with liver steatosis >60% by FibroScan (［258.73±52.54］dB/m vs ［327.42±49.08］dB/m，P=0.04).But there were no differences in CAP values among patients with liver steatosis less than 30%，between 30%-60%，and more than 60%.Conclusion CAP values by FibroTouch and FibroScan are positively correlated with body mass and degree of liver steatosis.CAP value is a good and noninvasive index to evaluate degree of liver steatosis.

Key words: FibroTouch, FibroScan, controlled attenuation parameters, liver steatosis, liver biopsy

中图分类号:

R445.1

朱梦飞，刘静，王洁，陈公英，娄国强，施军平. FibroTouch及FibroScan实施受控衰减参数评价肝细胞脂肪变与肝脏病理比较分析[J]. 中国实用内科杂志, DOI: 10.7504/nk2014050402.

ZHU Meng-fei，LIU Jing，WANG Jie，CHENG Gong-ying，LOU Guo-qing，SHI Jun-ping. Comparative analysis of controlled attenuation parameters in evaluation of liver steatosis using FibroTouch and FibroScan.[J]. Acta Metallurgica Sinica, DOI: 10.7504/nk2014050402.

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2014-02-12收稿 2014-03-15修回本文编辑：颜廷梅

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