中文摘要：

目的探讨肝脏瞬时弹性成像（FS）评估慢性HBV感染者肝纤维化的作用和影响因素。方法313例慢性HBV感染者在B型超声引导下，用“1s快速切割组织法”获取肝组织，FS检测肝硬度值（LSM），同时检测血清HBeAg、肝功能和留取人口学资料，并分析这些指标与LSM的相关性。两组资料比较采用f检验（数据符合正态分布）或Mann-WhitneyU检验（数据不符合正态分布）；相关性分析采用Spearman’S或Pearson’s相关系数；采用受试者工作特征（ROC）曲线和曲线下面积（AUC）判断LSM诊断肝组织纤维化分期≥s2的效能。结果LSM与肝组织炎症分级、纤维化分期呈正相关（HBeAg阳性组，值分别为0．428和0．402；HBeAg阴性组，值分别为0．296和0．283，P值均〈0．001）；LsM与性别、年龄、丙氨酸氨基转移酶（ALT）水平、总胆红素（TBil）水平间的相关性受HBeAg状态和AIJ水平影响，LSM与TBil只在HBeAg阴性组二者呈正相关（r=0．298，JD〈0．001）；无论是HBeAg阳性还是阴性组在ALlT≥2×正常值上限（ULN）组FS诊断肝纤维化≥S2的效能均低（AUG〈0．75，P〉0．05）；FS诊断肝纤维化≥S2的截点值随ALIT水平和HBeAg状态不同而异，在ALT〈1XULN和1～2×ULN组，FS诊断肝纤维化≥S2的截点值在HBeAg阳性和HBeAg阴性组中分别为5．85kPa、7．3kPa和6．35kPa、8．5kPa；只在ALT〈2×ULN的HBeAg阳性者中，LSM与年龄呈正相关（r=0．278，P=0．014），且对年龄〉30岁的诊断效能较高（AUC=0．867，P〈0．001），而对年龄≤30岁者诊断效能低（AUC=0．632，P〉0．05）。结论LSM与肝组织炎症分级、纤维化分期呈正相关，FS评估明显肝纤维化的截点值要结合年龄、ALIT水平、HBeAg状态，对年龄≤30岁者诊断效能低。

英文摘要：

Objective To investigate the role of FibroScan （FS） in liver fibrosis evaluation in patients with chronic hepatitis B virus （HBV） infection and related influencing factors. Methods A total of 313 patients with chronic HBV infection were enrolled, and liver tissue was obtained through ultrasound-guided ＂l-second fast tissue cutting＂. The liver stiffness measurement （LSM） was determined by FS, serum HBeAg and liver function were measured, and the patients＇ demographic data were recorded. The t-test was used for comparison of normally distributed data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed data between groups; the Spearman or Pearson correlation coefficient was used for correlation analysis; the ROC curve and AUC were used to evaluate the efficiency of FS in the diagnosis of liver fibrosis/〉 $2. Results LSM was positively correlated with liver inflammation grade and fibrosis stage （r = 0A28 and 0.402 in HBeAg- positive group andr = 0.296 and 0.283 in HBeAg-negative group, allP 〈 0.001）. The correlation of LSM with sex, age, alanine aminotransferase （ALT） level, and total bilirubin （TBil） was affected by HBeAg status and ALT level, and LSM was only positively correlated with TBil in HBeAg-negative group （r = 0.298, P 〈 0.001）. In patients with ALT 〉~ 2xupper limit of normal （ULN）, FS had a low efficiency in the diagnosis of liver fibrosis ≥S2 （AUC 〈 0.75, P 〉 0.05）, regardless of their HBeAg status. The cut-off values of FS in the diagnosis of liver fibrosis ≥S2 varied with ALT level and HBeAg status, and in the ALT 〈1×ULN and 1-2×ULN groups, the cut-off values of FS in the diagnosis of liver fibrosis 〉/$2 in patients with positive and negative HBeAg were 5.85 kPa/7.3 kPa and 6.35 kPaJ8.5 kPa, respectively. In the patients with positive HBeAg in ALT 〈 2×ULN group, LSM was positively correlated with age （r = 0.278, P = 0.014）. FS had relatively high diagnostic efficiency in patients aged 〉