彩色超声与慢性肝炎肝纤维化分期的相关性分析  

Value of color Doppler ultrasound in diagnosis of hepatitis B associated liver cirrhosis

作　　者：张洁[1] 刘丽丽[1] 叶军[1] 孙琳[1] 吴旸[2] 

机构地区：[1]上海中医药大学附属普陀医院感染科,200062 [2]上海中医药大学附属普陀医院超声室,200062

出　　处：《肝脏》2015年第4期298-301,共4页Chinese Hepatology

摘　　要：目的探讨超声诊断慢性乙型肝炎(CHB)患者代偿期肝硬化的价值。方法 2010年1月至2015年1月行肝活组织检查的CHB患者226例,收集患者B型超声资料,利用Logistic回归分析与代偿期肝硬化程度相关的指标,采用受试者工作特征曲线下面积(AUROC)评价B型超声诊断代偿期肝硬化的价值。结果超声指标中SWV、门静脉主干内径、胆囊壁厚度、脾脏长径、脾脏厚度、脾脏面积、脾静脉内径、门静脉最大流速共8项指标与肝脏炎症分级和纤维化分期均相关。其中,SWV、门静脉主干内径、脾脏长径、门静脉最大流速、脾静脉内径与组织学代偿期肝硬化独立相关,AUC均>0.7。结论超声的部分影像学指标对预测组织学代偿期肝硬化有潜在的价值。Objective To investigate the application of color Doppler ultrasound in diagnosis of early liver cirrhosis （S4）for patients with chronic hepatitis B （CHB）.Methods Ultrasound examinations of 226 CHB patients,which received liver biopsy in Putuo Hospital of Shanghai from January 2010 to January 2015,were collected.Logistic regression analysis was performed to determine factors independently correlated with early liver cirrhosis.Diagnostic value of ultrasound index was assessed by area under receiver operating characteristic curve （AUROC）.Results Eight indicators obtained from ultrasound （shear wave velocity,diameter of main portal vein,gallbladder wall thickness, spleen diameter, spleen thickness,splenic square area,inner diameter of splenic vein,maximum velocity of portal vein）were correlated with liver inflammation grades and fibrosis stages,respectively.Logistic regression analysis indicated that shear wave velocity, diameter of main portal vein,spleen diameter,portal venous velocity and inner diameter of splenic vein in ultrasound findings were independently correlated with early liver cirrhosis.AUROC was more than 0.7 in each indicators.Conclusion There is a potential value for some indicators from ultrasound in predicting early cirrhosis.

关 键 词：超声检查 肝硬化 肝炎 乙型 慢性 活组织检查 诊断 

分 类 号：R512.6[医药卫生—内科学] R575.2[医药卫生—临床医学]