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目的：探讨瞬时弹性成像（FibroScan）诊断慢性乙型肝炎肝纤维化的准确性。方法：选取慢性乙型肝炎患者289 例，其中未做病理组198 例，病理组91 例，正常对照50 例，病理组患者行病理肝纤维化检测，未做病理组患者检查B 超，全部患者及正常对照应用FibroScan 进行肝脏硬度检测（liver stiffness measurement，LSM）值测量。分析未做病理组慢乙肝组与正常对照组间及未做病理组慢乙肝组B 超肝纤维化各级间LSM 值的差异；病理慢乙肝组采用受试者工作特征（Receiver Operating haracteristic，ROC）曲线分析FibroScan 诊断肝纤维化的准确性，并得出各期诊断界值；根据该诊断界值对未做病理慢乙肝组进行FibroScan 肝纤维化分期，分析其与B超肝纤维化分级的一致性。结果：LSM 值在未做病理慢乙肝组和正常对照组间及B 超肝纤维化各级间差别显著（P< 0.05）；其中病理组统计结果显示F1、F2、F3、F4 期肝纤维化的ROC 曲线下面积（Area under Receiver Operating Characteristic，AUROC）分别为0.726、0.847、0.806、0.864，诊断界值分别为6.5、7.4、10.1、17.0 kPa，敏感性分别为69.62 %、68.33 %、66.67 %、72.22 %，特异性分别为66.67 %、87.10 %、85.71 %、91.78 %；肝纤维化的FibroScan 分期和B 超分级具有一致性 (Kappa值=0.366，P < 0.05)。结论：FibroScan 对慢性乙型肝炎肝纤维化尤其是严重肝纤维化及肝硬化诊断准确性高，具有良好的临床应用价值。

英文摘要:

Objective:To explore the accuracy of transient elastography (FibroScan) for the detection of liver fibrosis.Methods:A total of 289 patients diagnosed with chronic hepatitis B were involved in the study，non-pathology group (198 subjects), pathology group (91 subjects) and the control group(50 subjects). Pathology group were subjected to liver biopsy, Non-pathology group were examined by B-ultraosound，meanwhile, FibroScan was used for liver stiffness measurement (LSM) of everyone. The differences of LSM between control group and non-pathology group and LSMdifferences between B-ultrasound liver fibrosis levels of non-pathology were analyzed. In pathology group, the Receive Operating Characteristic (ROC) curve was adopted to analyze the accuracy of FibroScan for diagnosing liver fibrosis and the diagnostic cutoffs were counted. Liver fibrosis levels of non-pathology group were staged by cutoffs above and also classified by B-ultrosound, the consistency of them was analyzed. Results:LSM differences between control group and non-pathology group and that between B-ultraosound liver fibrosis levels of non-pathology were significantly different（P<0.05）. The statistical results pathology group show that the areas under the ROC curve were 0.726, 0.847, 0.806, 0.864 for patients with fibrosis F1, F2, F3, F4, the cutoff values were 6.5, 7.4,10.1,17.0 kPa, the sensitivities were 69.62%, 68.33 %, 66.67 %, 72.22 %, the specificities were 66.67 %, 87.10 %, 85.71 %, 91.78 %. Liver fibrosis staged by FibroScan was consistent with that classified B-ultrosound (Kappa=0.366, P<0.05).Conclusion:The diagnosis of liver fibrosis of chronic hepatitisB especially severe fibrosis and cirrhosis by FibroScan has high accuracy. FibroScan is valuable for clinic application.

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