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(FS)诊断异体肝移植后复发丙肝肝纤维化程度

更新时间:2009-8-4

背景:FS是通过测量肝脏硬度诊断肝纤维化的简单无创方法,因此有望代替肝穿诊断肝纤维化。我们以异体肝移植后复发丙肝的患者为研究对象,通过与生化指标的对照来评估FS诊断肝纤维化的准确性。

方法:56名受试患者均系异体肝移植后再次感染丙肝,均行肝穿和肝脏硬度检测,将肝穿结果与肝弹性结果比较分析。

结果:肝穿结果肝纤维化F0F1F2F3F4分别为22人,13人,9人,7人,5人。其肝脏硬度值波动于2.9 72.0 kPa,最优cut-off值分别为:F18.8kpaF29.9kpaF315.4kpaF426.5kpa。诊断肝纤维化F2时,ROC曲线下面积为0.92,而通过血清学指标透明质酸,四型胶原,丙氨酸转氨酶,APRI诊断的ROC曲线下面积分别为:0.52, 0.62, 0.64, and 0.70

结论:对于异体肝移植后复发丙肝患者,FS是检测其肝纤维化的简单,无创,可靠的工具。

 来源:Transplantation. 2008 Jan 15;85(1):69-74.

原文:

Assessment of graft fibrosis by transient elastography in patients with recurrent hepatitis C after living donor liver transplantation.

Harada N, Soejima Y, Taketomi A, Yoshizumi T, Ikegami T, Yamashita Y, Itoh S, Kuroda Y, Maehara Y.

Department of Surgery and Medical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. nharada@surg2.med.kyushu-u.ac.jp

BACKGROUND: Transient elastography (FibroScan) is a simple and noninvasive method to assess liver fibrosis by measuring liver stiffness and therefore can be a promising tool to evaluate liver fibrosis and avoid liver biopsy. We prospectively assessed the performance of transient elastography in patients with recurrent hepatitis C virus after living donor liver transplantation, in comparison with the surrogate serum markers.

METHODS: Fifty-six patients with recurrent hepatitis C virus after living donor liver transplantation, who underwent both liver biopsy and transient elastography were included in this study. The grade of liver fibrosis (the Scheuer classification) obtained by biopsy was compared to liver stiffness measured by the transient elastography.

RESULTS: The fibrosis grades were as follows: F0, n=22; F1, n=13; F2, n=9; F3, n=7; and F4, n=5. Liver stiffness values ranged from 2.9 to 72.0 kPa. The optimal cutoff values were 8.8 kPa for F>or=1, 9.9 kPa for F>or=2, 15.4 kPa for F>or=3, and 26.5 kPa for F>or=4. The area under the receiver operator characteristic curve for the diagnosis of fibrosis (F>or=2) by transient elastography was 0.92, while that by hyaluronic acid, type 4 collagen, alanine aminotransferase, and the aspartate transaminase to platelets ratio index were 0.52, 0.62, 0.64, and 0.70, respectively.

CONCLUSIONS: These data suggest that transient elastography is a simple, noninvasive and reliable tool to assess liver fibrosis in patients with recurrent hepatitis C virus after living donor liver transplantation.

PMID: 18192914 [PubMed - indexed for MEDLINE]

 

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