彩色多普勒超声半定量评分对早期慢性乙型病毒性肝炎肝硬化的诊断价值  

Evaluation of color doppler ultrasound semi-quantitative score for diagnosis of early hepatitis after chronic hepatitis type B

作　　者：夏柏 徐韦[1] 严志涵[2] 

机构地区：[1]东南大学附属中大医院超声诊断科,江苏南京210044 [2]无锡市第五人民医院肝病科,江苏无锡214005

出　　处：《临床和实验医学杂志》2017年第1期60-63,共4页Journal of Clinical and Experimental Medicine

基　　金：南京医科大学科技发展基金项目(编号:2013NJMU197)

摘　　要：目的探讨彩色多普勒超声半定量评分对早期慢性乙型病毒性肝炎肝硬化的临床诊断价值。方法选取2013年7月到2015年7月期间经检查确诊为慢性乙型病毒性肝炎的患者92例,均行肝穿刺病理组织学检查且根据结果将其分为非肝硬化组54例以及早期肝硬化组38例。给予两组患者相同的彩色多普勒超声检查,并对其进行半定量评分。结果早期肝硬化组患者的肝脏实质回声、肝脏表面被膜、肝静脉清晰度、肝脏边缘形态、脾脏面积、胆囊壁以及肝内韧带彩色多普勒超声半定量评分的得分明显高于非肝硬化组,差异均具有统计学意义(P<0.05)。彩色多普勒超声半定量评分对慢性病毒性肝炎早期肝硬化患者的诊断灵敏度、特异度、阳性预测值及阳性预测值均较高。结论彩色多普勒超声半定量评分对照的慢性乙型病毒性肝炎患者早期肝硬化的肝脏各指标变化具有密切的联系,临床上可用于患者早期肝硬化的诊断,且具有较高的准确度,值得推广运用。Objective To investigate the evaluation of color Doppler ultrasound semi- quantitative score for early clinical diagnosis of chronic hepatitis b viral hepatitis cirrhosis of the liver. Methods 92 cases of patients with chronic hepatitis b viral hepatitis in July 2013 to July2015 in our hospital were selected,and liver biopsy in histological tests had confirmed infection with chronic hepatitis type B,after deal with liver biopsy in histological examination. According to the results,it can be divided into the group of 54 cases（ control group） and early cirrhosis of the liver cirrhosis group（ observation group） in 38 cases. Two groups of patients performed the same color Doppler ultrasound,and were semi- quantitatively scored. Results Compared with the group with no liver cirrhosis,the liver parenchyma echo,the surface of the liver capsule,hepatic vein,spleen,liver edge form clear area,the gallbladder wall and intrahepatic ligament of color doppler ultrasound semi- quantitative score in early cirrhosis group were significantly higher than those of no cirrhosis group,and the differences were statistically significant（P〈0. 05）. Color doppler ultrasound semi- quantitative score in patients with early chronic viral hepatitis cirrhosis had high diagnostic sensitivity,specific,positive predictive value and negative predictive value. Conclusion Color Doppler ultrasound semi- quantitative score has close relation with various index changes of early chronic hepatitis b patients,and it can be used for early diagnosis of liver cirrhosis patients with higher accuracy. And,it is worth promoting in clinical application.

关 键 词：慢性乙型病毒性肝炎 早期肝硬化 彩色多普勒超声 半定量评分 

分 类 号：R445.1[医药卫生—影像医学与核医学] R512.62[医药卫生—诊断学] R575.2[医药卫生—临床医学]