肝剪切波速在慢性乙型肝炎病毒携带者肝纤维化分期上的临床意义  

The clinical significance of liver shear wave velocity on hepatic fibrosis staging

作　　者：邱梅[1] 胡萍香[1] 周大桥[1] 童光东[1] 唐海鸿[1] 高辉[1] 贺劲松[1] 郑颖俊[1] 陈亮[1] 占伯林[1] 

机构地区：[1]广州中医药大学深圳附属医院肝病科,广东深圳518033

出　　处：《临床肝胆病杂志》2010年第4期407-409,共3页Journal of Clinical Hepatology

基　　金：国家十一五科技重大专项"艾滋病和病毒性肝炎等重大传染病防治"(2008ZX10005-008)

摘　　要：目的了解慢性乙型肝炎病毒(HBV)携带者肝纤维化分期与肝剪切波速之间的关系,提供慢性HBV携带者肝纤维化判断的无创性预测指标。方法对118例临床诊断为慢性HBV携带者的患者进行肝活组织检查,再使用西门子超声的声脉冲辐射力成像技术(ARFI)分别测定肝脏的剪切波速,以50例健康人群为对照,比较各纤维化分期与肝剪切波速之间的关系,同时把可能与其有关系的因素如年龄、性别、病程、ALT水平、体重指数(BMI)、HBVDNA定量、炎症活动度(G)等代入Logistic回归方程式进行分析。结果与健康正常对照者比较,肝纤维化不同分期之间剪切波速单向方差分析差异显著(F=25.452,P=0.000),肝剪切波速与病理纤维化分期呈正相关;肝剪切波速对S3的诊断价值最高(ROC:0.95),非条件Logistic回归分析显示:BMI、病程和年龄可影响测得的肝剪切波速。结论肝剪切波速可做为一种无创的预测临床诊断为慢性HBV携带者肝纤维化程度的参考指标。Objective To study the relationship between liver shear wave velocity and classification of hepatic fibrosis in order to establish a non-invasive diagnostic method for hepatic fibrosis staging in chronic HBV carrier.Methods 118 chronic HBV carriers were diagnosed according to clinical manifestations,biopsy and the liver shear wave velocity.50 persons were included as healthy controls.The correlation between age,gender,disease course,ALT,body mass index（BMI）,HBVDNA and inflammation grade were analyzed by Logistic regression and one-way ANOVA analysis.Results Compared to the control group,the fibrosis staging and liver shear wave velocity were positively correlated（F=25.452,P=0.000）,The diagnostic value of liver shear wave velocity for S3 was significant（ROC：0.95）.The analysis of unconditional Logistic Regression showed that BMI,disease course and age could affect the results of liver shear wave velocity.Conclusion Liver shear wave velocity could be a non-invasive reference factor for staging hepatic fibrosis in chronic HBV carrier.

关 键 词：带病原状态 肝炎 乙型 慢性 肝硬化 声脉冲辐射力技术 

分 类 号：R512.62[医药卫生—内科学]