| Objectives The aim of this study was to explore the diagnostic value of Fibro Scan for liver fibrosis in patients with chronic hepatitis B(CHB)and normal alanine aminotransfe-rase.Methods A total of 154 patients with CHB who were admitted to the Tangshan Infectious Diseases Hospital from September 2014 to September 2017 for Fibroscan and Liver biopsy were collected.The liver stiffness measurements(LSM)and pathological stage of liver fibrosis were recorded in all patients.Based on the liver biopsy stage as the gold standard,patients were divided into liver fibrosis group(including stage F1,F2,F3,F4)and control group(stage F0,no fibrosis).The results of statistical analysis were obtained by SPSS19.0 software,and the continuous variables were interpreted as mean ± standard deviation.Independent sample t test was used for comparison between the two groups.Based on the LSM mean of the case group,the LSM levels in case group and control group were roughly divided into exposed group and non-exposed group,and the non-reference test was performed on both exposed and non-exposed groups.The variance analysis was used to compare different stages of liver fibrosis,the subjects working characteristic curve of liver stiffness measurements in each stage of liver fibrosis was plotted based on the liver biopsy results as the gold standard,and the area under the curve was calculated.The principle that the maximum value of the sum of sensitivity and specificity is the best diagnostic cut-off value was used to determine the cut-off value of different stages of hepatic fibrosis,with a statistical significance of P<0.05.Results 1 The case group consisted of 124 cases of liver fibrosis and the control group consisted of 30 cases without fibrosis.The liver stiffness measurement in the case group was(16.23±7.17)k Pa,and the liver stiffness measurement in the non-fibrosis group was(6.31±2.6)k Pa.The independent sample t-test between the two groups was t=5.288,P=0.000,indicating that there were significant differences between the two groups;2 In the case group,50 cases were exposed and 74 cases were unexposed.In the control group,3 cases were exposed and 27 cases were unexposed.The non-reference test in the exposed and non-exposed groups showed that the chi-squared value between groups was ?2=9.840,P=0.002 and OR=6.08,that is,the exposure group was 6 times higher than the non-exposed group with liver fibrosis risk factor;3 The liver stiffness measurement increased with the degree of liver fibrosis,and there was a significant positive correlation between the two groups(rs=0.741,P<0.000);4 The best cut-off value of Fibro Scan for diagnosing stage F ? 1(liver fibrosis stage),stage F ? 2(advanced stage of liver fibrosis),stage F ? 3(severe stage of liver fibrosis),F4 stage(stage of liver cirrhosis)was 7.25 k Pa,9.9k Pa,11.3k Pa,17.4k Pa,and the area under receiver operating characteristic was 0.850,0.828,0.855 and 0.851,respectively.Conclusions 1 There was a vital indubitable correlation between LSM and the ponderance of liver fibrosis in chronic hepatitis B,and LSM increased with the degree of fibrosis.2 LSM value can be used as a reference to determine the severity of liver fibrosis in patients with chronic hepatitis B.3 Fibro Scan for the diagnosis of liver fibrosis stage has a good meaning,can accurately discriminate between diverse degree of fibrosis in sufferers with chronic hepatitis B,in which the diagnosis value of severe stage of liver fibrosis,the highest sensitivity,specific degrees.4 Fibro Scan is essential for assessing the grade of liver fibrosis in patients with CHB and normal ALT.Fibro Scan has a high accuracy,regular LSM testing can be done early diagnosis of liver cirrhosis,especially for patients with clinically compensated liver function and no substantial changes in imaging. |
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