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만성 B형 간염환자에서 간탄력도 측정에 의한 간섬유화의 비침습적 평가

Other Titles
 Non-invasive assessment of liver fibrosis by measuring the liver stiffness and biochemical markers in chronic hepatitis B patients 
Authors
 김화숙  ;  김자경  ;  박영년  ;  명성민  ;  방미선  ;  윤기태  ;  이근호  ;  백용한  ;  이관식  ;  안상훈  ;  전재윤  ;  문영명  ;  한광협 
Citation
 Korean Journal of Medicine, Vol.72(5) : 459-469, 2007 
Journal Title
 Korean Journal of Medicine 
ISSN
 1738-9364 
Issue Date
2007
Abstract
Background: Transient elastography (FibroScan(R)) is a rapid and non-invasive method to measure liver stiffness and this allow the assessment of liver fibrosis. The aim of this study was to assess the diagnostic accuracy of measuring the liver stiffness in addition to measuring the other biochemical markers such as the aspartate transaminase to platelet ratio index [APRI] and the AST/ALT ratio. Methods: We enrolled 228 HBsAg positive patients whose liver stiffness was measured by FibroScan(R) between March 2005 and September 2005. Liver biopsy examinations were performed in 34 patients. The fibrosis (F) was staged on a 0-4 scale according to the Ludwig classification. Results: According to the clinical diagnosis, the median values of liver stiffness were 7.0±2.7 kPa for inactive carriers (n=29), 8.3±5.3 kPa for chronic hepatitis patients (n=106), 15.9±8.3 kPa for compensated cirrhosis patients (n=63), 31.8±20.3 kPa for decompensated cirrhosis patients (n=26), and 45.1±34.5 kPa for HCC patients (n=4). The degree of liver stiffness was significantly different between the different disease groups (p<0.001). Liver stiffness was well correlated with the fibrosis stages (r=0.726; p< 0.001). The AUROC of FibroScan(R), the APRI and the AST/ALT ratio values were of the same order; 0.72, 0.61 and 0.58, respectively, for F≥2; 0.92, 0.73, and 0.56, respectively, for F≥3; and 0.97, 0.79, and 0.55, respectively, for F=4. FibroScan(R) offered the best diagnostic performance both for significant fibrosis (F≥2) and severe fibrosis-cirrhosis (F3-F4). Conclusions: FibroScan(R) is a reliable, rapid non-invasive method to diagnose the severity of chronic liver disease and to predict fibrosis in patients with chronic hepatitis B, in addition to using the APRI and AST/ALT ratio.
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Appears in Collections:
5. Research Institutes (연구소) > Institute of Gastroenterology (소화기병연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hwa Sook(김화숙)
Myung, Sung Min(명성민)
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Paik, Yong Han(백용한)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Yoon, Ki Tae(윤기태)
Lee, Kwan Sik(이관식) ORCID logo https://orcid.org/0000-0002-3672-1198
Lee, Keun Ho(이근호)
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/97670
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