Hepatus®评估慢性乙型肝炎肝纤维化的可靠性

Jessica Cynthia Febryani, M. B. Bestari, H. ., Dolvy Girawan, N. Agustanti, Yudi Wahyudi, S. Abdurachman
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摘要

在肝纤维化评估的非侵入性策略中,瞬态弹性成像因其无创性和可重复而被广泛使用。Hepatus®(迈瑞,中国)是一种用于测量肝脏硬度的新型仪器,目前在市场上的价格低于其前体FibroScan®(Echosens,巴黎)。方法在本横断面研究中,于2021年10月至2021年12月连续招募单中心CHB患者。在一次访问中使用两种瞬态弹性仪检查患者的LSM。第一台仪器为Hepatus®(迈瑞,中国),第二台仪器为FibroScan®(Echosens,巴黎)。这两项测量都是由同一个操作者完成的。结果共纳入68例慢性乙型肝炎患者。Hepatus®和FibroScan®对LSM的中位评分分别为7.6(5.92-11.88)和7.35(5.63-11.80)。Spearman秩分析法显示两种仪器的结果有显著的相关性(r= 0.8, p 0.05)。Hepatus®和FibroScan®鉴定的显著纤维化(≥8 kPa)患者分别为28例(41%)和29例(43%)。McNemar检验结果无显著性差异(p= 1.000), Cohen 's kappa一致性测量显示中度一致性(κ = 0.789, p 0.005)。结论hepatus®与FibroScan®鉴别出相似数量的显著纤维化患者,两种仪器的肝硬度测量结果具有显著相关性。Hepatus®有潜力以更经济的价格作为测量肝脏硬度的替代工具。关键词:shepatus®,FibroScan®,瞬态弹性成像,肝纤维化,CHB
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Reliability of Hepatus® for Evaluating Liver Fibrosis in Chronic Hepatitis B
Abstract  BackgroundAmong non-invasive strategies available for liver fibrosis assessment, transient elastography is widely used, as it is non-invasive and can be repeated. Hepatus® (Mindray, China) is one novel instrument for measuring liver stiffness that is now available in the market with lower price than its precursor, FibroScan® (Echosens, Paris). MethodIn this cross sectional study, CHB patients in single center were recruited consecutively in October 2021-December 2021. The patients were examined for LSM with two transient elastography instruments in one visit. The first instrument was Hepatus® (Mindray, China) and the second one was FibroScan® (Echosens, Paris). Both measurements were done by the same operator. ResultsA total of 68 CHB patients were enrolled in this study. Median score of LSM by Hepatus® and FibroScan® were 7.6 (5.92-11.88) and 7.35 (5.63-11.80) respectively. Spearman rank analysis for correlation showed a significant correlation between the results of the two instruments ( r= 0.8, p 0.05). The number of patients with significant fibrosis (≥8 kPa) identified by Hepatus® and FibroScan® were 28 (41%) and 29 (43%) respectively. McNemar test yielded no significant difference of the results (p= 1.000), and Cohen’s kappa measure of agreement showed moderate agreement (κ = 0.789 and p 0.005). ConclusionHepatus® identified similar number of significant fibrosis patients with FibroScan®, with the results of liver stiffness measurement between the two instruments correlated significantly. Hepatus® has a potential as an alternative tool  for measuring liver stiffness with a more economic price. KeywordsHepatus®, FibroScan®, transient elastography, liver fibrosis, CHB
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