声辐射力脉冲成像技术在评估中西医结合治疗慢性乙型病毒性肝炎合并肝纤维化疗效中的应用  

Application of acoustic radiation force impulse in efficacy evaluation of integrated treatment of traditional Chinese and western medicine in chronic hepatitis B patients complicated with liver fibrosis

作　　者：张宇[1] 董常峰[1] 李汉英[1] 骆永芳[1] 李玉丹[1] 

机构地区：[1]广东省深圳市第三人民医院超声科,广东深圳518112

出　　处：《实用临床医药杂志》2016年第7期45-47,51,共4页Journal of Clinical Medicine in Practice

基　　金：王宝恩基金资助项目(xjs20121010);广东省深圳市科技计划项目(JCYJ20140411112047885)

摘　　要：目的探讨声辐射力脉冲成像技术(ARFI)在评估恩替卡韦(ETV)联合复方鳖甲软肝片治疗慢性乙型病毒性肝炎(CHB)合并肝纤维化疗效中的作用。方法将60例CHB合并肝纤维化患者随机分为A、B 2组,每组30例。A组给予ETV联合复方鳖甲软肝片治疗,B组给予ETV联合安慰剂治疗。治疗前后,分别检测肝功能及肝纤维化相关指标,行ARFI检查,并评估其检查准确率。结果治疗后,2组丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、透明质酸(HA)、层粘连蛋白(LN)、IV型胶原(IV-C)水平均较治疗前明显降低(P<0.01),其中A组降低幅度更为显著(P<0.01)。治疗后,A组ARFI检测均值明显下降(P<0.01),B组无明显变化,2组比较差异有统计学意义(P<0.05)。ARFI对S4期的诊断性能最好,诊断准确率高达98%。结论 ETV联合复方鳖甲软肝片能有效改善CHB合并肝纤维化患者的肝功能,抑制肝纤维化进展。ARFI可作为评估肝纤维化程度的一种无创检查方法。Objective To evaluate the effect of acoustic radiation force impulse（ ARFI） on efficacy evaluation of entecavir（ ETV） combined with compound biejia ruangan tablet in chronic hepatitis B（ CHB） patients complicated with liver fibrosis. Methods Sixty patients with CHB and liver fibrosis were randomly divided into group A（ n = 30） and group B（ n = 30）. The patients in group A were treated with ETV and compound biejia ruangan tablet,while those in group B were treated with ETV and placebo. The related indexes of liver function and liver fibrosis were respectively detected before and after treatment. ARFI examination was performed,and its accuracy rate was assessed. Results After treatment, the levels of alanine aminotransferase（ ALT）, aspartate transaminase（ AST）,hyaluronic acid（ HA）,laminin（ LN） and type IV collagen（ IV-C） in both groups decreased significantly when compared with those before treatment（ P〈0. 01）,and the decreased range of group A was greater than group B（ P〈0. 01）. The mean value of ARFI in group A reduced significantly after treatment（ P〈0. 01）,whereas that in group B had no change,and there was no significant difference between two groups（ P〈0. 05）. The diagnostic performance of ARFI to stage S4 was the best,and the diagnostic accuracy rate was 98%. Conclusion ETV combined with compound biejia ruangan tablet can effectively improve the liver function and inhibit the progression of liver fibrosis in the treatment of CHB patients with liver fibrosis. ARFI can be considered as a non-invasive examination method for evaluating the degree of liver fibrosis.

关 键 词：声辐射力脉冲成像技术 慢性乙型病毒性肝炎 肝纤维化 恩替卡韦 复方鳖甲软肝片 

分 类 号：R512.6[医药卫生—内科学]