FibroScan在乙型肝炎肝纤维化及肝硬化中的 应用研究进展

Research Progress on the Application of FibroScan in Hepatitis B-Related Hepatic Fibrosis and Cirrhosis

摘要: 乙型肝炎病毒(HBV)感染是全球范围内导致慢性肝病的主要原因之一，肝纤维化与肝硬化作为其病程进展中的核心严重并发症，关乎患者的疾病转归与生存预后，因此实现对肝纤维化、肝硬化的精准评估是HBV相关肝病临床管理的关键。非侵入性诊断技术的创新应用，为提升乙肝患者诊疗效能、改善预后提供了重要支撑，其中FibroScan凭借瞬时弹性成像技术，通过量化检测肝组织硬度来评估肝纤维化与肝硬化程度，已成为临床广泛应用的无创诊断手段，且大量研究证实其在HBV相关肝纤维化及肝硬化的诊断中具备较高的灵敏度与特异性。本文系统梳理近年来FibroScan在乙型肝炎肝纤维化及肝硬化领域的研究进展，重点探讨其临床应用优势与现存局限性。现有基础研究与临床数据表明，FibroScan可快速、精准地判定肝纤维化与肝硬化的分级程度，其检测结果与传统肝穿刺活检的病理诊断具有高度一致性，既有效规避了有创操作的相关风险，又能为临床动态监测病情进展提供可靠的量化依据。但该技术的诊断准确性仍受多种因素制约，有待进一步深入探究：不同病因引发的肝病存在病理特征差异，易对肝硬度值的判读造成干扰；肥胖患者的皮下脂肪层会影响检测信号的有效传导；而处于肝脏炎症活动期的患者，肝细胞水肿等病理改变可导致肝硬度值假性升高，进而降低诊断的精准性。尽管存在上述局限，随着技术的持续迭代升级与相关研究的不断深化，FibroScan在HBV相关肝病全程管理中的应用潜力与价值仍值得期待。本综述在全面总结FibroScan应用现状的基础上，对其未来发展方向进行展望，以期为乙型肝炎肝纤维化及肝硬化的精准诊治提供科学的理论参考与实践依据。

Abstract: Hepatitis B virus (HBV) infection is one of the leading causes of chronic liver disease worldwide. Hepatic fibrosis and cirrhosis, as core severe complications during its disease progression, are closely related to patients’ disease outcomes and survival prognosis. Therefore, achieving accurate assessment of hepatic fibrosis and cirrhosis is the key to the clinical management of HBV-related liver diseases. The innovative application of non-invasive diagnostic technologies has provided important support for improving the diagnosis and treatment efficacy of hepatitis B patients and enhancing their prognosis. Among these technologies, FibroScan, relying on transient elastography to quantitatively detect liver tissue stiffness for evaluating the degree of hepatic fibrosis and cirrhosis, has become a widely used non-invasive diagnostic tool in clinical practice. A large number of studies have confirmed that FibroScan has high sensitivity and specificity in the diagnosis of HBV-related hepatic fibrosis and cirrhosis. This paper systematically sorts out the research progress of FibroScan in the field of hepatitis B-related hepatic fibrosis and cirrhosis in recent years, focusing on discussing its clinical application advantages and existing limitations. Existing basic research and clinical data show that FibroScan can quickly and accurately determine the grading of hepatic fibrosis and cirrhosis, and its detection results are highly consistent with the pathological diagnosis of traditional liver biopsy. It not only effectively avoids the risks associated with invasive operations but also provides a reliable quantitative basis for the dynamic monitoring of disease progression in clinical practice. However, the diagnostic accuracy of this technology is still restricted by various factors and needs further in-depth exploration: differences in pathological characteristics of liver diseases caused by different etiologies are likely to interfere with the interpretation of liver stiffness values; the subcutaneous fat layer of obese patients will affect the effective conduction of detection signals; and in patients with active liver inflammation, pathological changes such as hepatocellular edema can lead to a false increase in liver stiffness values, thereby reducing diagnostic accuracy. Despite the above limitations, with the continuous iterative upgrading of technology and the deepening of relevant research, the application potential and value of FibroScan in the whole-course management of HBV-related liver diseases are still promising. On the basis of comprehensively summarizing the current application status of FibroScan, this review looks forward to its future development direction, aiming to provide scientific theoretical reference and practical basis for the precise diagnosis and treatment of hepatitis B-related hepatic fibrosis and cirrhosis.