Noninvasive diagnosis and prognosis of liver cirrhosis: a comparison of biological scores, elastometry, and metabolic liver function tests
Noninvasive diagnosis and prognosis of liver cirrhosis: a comparison of biological scores, elastometry, and metabolic liver function tests
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DOI：
10.1097/meg.0b013e3283343f58
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发表时间：
2010-05-01
影响因子：
2.1
通讯作者：
Mion, Francois
中科院分区：
文献类型：
--
作者：
Forestier, Julien;Dumortier, Jerome;Mion, Francois
背景最近，诊断肝硬化的无创方法已得到广泛发展。我们评估了肝脏刚度测量，天冬氨酸氨基转移酶与体积比例指数（APRI）得分，C-13-氨基氨基林呼吸测试和氨基氨基氨基绿色血浆清除率，以诊断患有慢性肝病患者的Cirrhosis，并进行预测。肝硬化患者的严重并发症。总共296例慢性患者研究了各种原因的肝病。通过接收器操作特征曲线分析评估诊断精度。接收器操作特征曲线的诊断为cirrhosis诊断的区域为（95％置信区间）0.93（0.90-0.96）（0.90-0.96）（0.90-0.96）的肝脏刚度测量，0.82（0.77-0.87）（0.77-0.87）（0.77-0.87）（0.77-0.87）（0.77-0.87） -13-氨基吡啶呼吸测试，APRI得分为0.81（0.76-0.86）。使用14.1 kPa的肝脏刚度的临界值，C-13-氨基肾上腺素呼气测试的剂量为4.15％/h，APRI得分为1，诊断肝硬化的阳性预测值约为90％。使用65.2 kPa的临界值用于肝僵硬，C-13-氨基肾上腺素呼气测试1.17％/小时，APRI得分为2.82，吲哚氰胺绿色等离子体清除率为51.1％，阳性预测值约为80％。肝硬化患者的严重并发症。结论肝僵硬度测量，C-13-氨基肾上腺素呼吸测试，吲哚羟氨酸绿色血浆清除和APRI评分是可靠的无创方法，用于诊断各种原因的慢性肝病患者的肝硬化，并且也是严重的预后指示剂肝硬化患者的并发症。 EUR J GASTROENTEROL HEPATOL 22：532-540（c）2010年狼kluwer Health | Lippincott Williams＆Wilkins。
Background Recently, noninvasive methods for the diagnosis of liver cirrhosis have been extensively developed. We assessed the accuracy of liver stiffness measurement, aspartate aminotransferase-to-platelet ratio index (APRI) score, C-13-aminopyrine breath test, and indocyanine green plasma clearance for the diagnosis of cirrhosis in patients with chronic liver disease and for the prediction of severe complications in cirrhotic patients.Methods A total of 296 consecutive patients with chronic liver diseases of various causes were studied. Diagnostic accuracy was assessed by receiver operating characteristic curve analysis.Results Areas under the receiver operating characteristic curve for the diagnosis of cirrhosis were (95% confidence interval) 0.93 (0.90-0.96) for liver stiffness measurement, 0.82 (0.77-0.87) for C-13-aminopyrine breath test, and 0.81 (0.76-0.86) for APRI score. Using cutoff values of 14.1 kPa for liver stiffness, 4.15% dose/h for C-13-aminopyrine breath test, and 1 for APRI score, the positive predictive value was approximately 90% for the diagnosis of cirrhosis. Using cutoff values of 65.2 kPa for liver stiffness, 1.17% dose/h for C-13-aminopyrine breath test, 2.82 for APRI score, and 51.1% for indocyanine green plasma clearance, the positive predictive value was approximately 80% for the occurrence of severe complications among cirrhotic patients. Conclusion Liver stiffness measurement, C-13-aminopyrine breath test, indocyanine green plasma clearance, and APRI score are reliable noninvasive methods for the diagnosis of cirrhosis in patients with chronic liver diseases of various causes, and are also prognostic indicators for the occurrence of severe complications in cirrhotic patients. Eur J Gastroenterol Hepatol 22:532-540 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.