目的:描述初级保健(PC)高危人群中肝纤维化患者的比例。要知道FIB-4和过渡弹性成像(TE)之间的一致性,PC和TE医院护理(HC)之间的观察员协议,和相关风险因素(RF)。
方法:观察性,描述性,描述性≥16岁的慢性肝病RF的横断面研究。性别和年龄,RF(肝脏检查改变(LT),代谢综合征,糖尿病,肥胖,酒精消费,肝脂肪变性),和FIB-4,PC和HC中的受控衰减参数和TE,被收集。根据共识算法,FIB-4≥1,3的患者在PC中进行振动控制TE,测量值≥8kPa的患者转诊至HC.
结果:研究了326例患者。71%的人没有提到HC,由于肝脏硬度<8kPa。95个衍生物中的83个在HC中确实是TE。45例(54%)TE≥8,25例(30%)≥12。僵硬度≥8kPa的患者比例为13,8%(45/326)和≥12kPa,7,6%(25/326)。FIB-4的预测值很低。PC和HC中TE的观察者间相关系数为0,433。PC中与TE≥8相关的变量:LT更改,糖尿病和脂肪变性。TE≥12:LT改变,糖尿病和肥胖。
方法:LT改变与肥胖。
结论:该研究支持血清指标和TE作为PC高危人群纤维化筛查的顺序表现,这可以减少转诊到AH的患者的百分比,和更好的风险患者分层。
OBJECTIVE: To describe the proportion of patients with liver fibrosis in at-risk populations in primary care (PC). To know the agreement between FIB-4 and transitional elastography (TE), interobserver agreement between PC and hospital care (HC) in TE, and associated risk Factors (RF).
METHODS: Observational, descriptive, cross-sectional study in ≥16 years of age with RF for chronic liver disease. Sex and age, RF (alteration of liver tests (LT), metabolic syndrome, diabetes, obesity, alcohol consumption, hepatic steatosis), and FIB-4, controlled attenuation parameter and TE in PC and in HC, were collected. According to a consensus algorithm, vibration-controlled TE was performed in PC in patients with FIB-4≥1,3, and those with measurement≥8 kPa were referred to HC.
RESULTS: 326 patients were studied. 71% were not referred to HC, due to liver stiffness<8 kPa. 83 of the 95 derivations did TE in HC. 45(54%) had TE≥8, and 25(30%)≥12. The proportion of patients with stiffness≥8 kPa was 13,8%(45/326) and ≥12 kPa, 7,6%(25/326). The predictive values of the FIB-4 were low. The interobserver correlation coefficient between TE in PC and HC was 0,433. Variables associated with TE≥8 in PC: LT alteration, diabetes and steatosis. With TE≥12: LT alteration, diabetes and obesity.
METHODS: LT alteration and obesity.
CONCLUSIONS: The study supports the sequential performance of serum indices and TE as a screening for fibrosis in the at-risk population in PC, which allows a reduction in the percentage of patients referred to AH, and a better stratification of risk patients.