实时剪切波弹性成像检测免疫清除期慢性乙型肝炎患者肝纤维化程度的研究  

Study on the liver fibrosis in patients with chronic hepatitis B during immune clearance stage by real time shear wave elastography

作　　者：单妍 夏冰[1] 何萍 杨保建 唐曼 韩力群[1] 

机构地区：[1]解放军第一一三医院特诊科,浙江省宁波市315040

出　　处：《临床超声医学杂志》2017年第10期663-665,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨实时剪切波弹性成像(SWE)在检测免疫清除期慢性乙型肝炎患者肝纤维化程度中的临床应用价值。方法应用SWE技术测量213例免疫清除期慢性乙型肝炎患者的肝脏弹性模量值,以病理结果为金标准,分析免疫清除期慢性乙型肝炎患者肝脏纤维化分期与SWE测值间的相关性;应用ROC曲线分析SWE诊断≥S2期肝纤维化的效能。结果 213例患者肝纤维化S0、S1、S2及S3~S4期的弹性模量值分别为(6.73±2.04)k Pa、(7.06±2.60)k Pa、(88.34±4.12)k Pa及(12.82±6.63)k Pa,差异有统计学意义(F=22.141,P<0.01)。肝脏弹性模量值与免疫清除期肝纤维化程度呈正相关(r=0.488,P=0.000)。SWE诊断≥S2期肝纤维化的ROC曲线下面积为0.739,截断值为8.81 k Pa,敏感性为58.8%,特异性为81.9%。结论 SWE技术可为诊断免疫清除期慢性乙型肝炎患者肝纤维化分期提供参考依据,为进一步治疗及预后提供一定帮助。Objective To investigate the clinical application value of liver fibrosis in patients with chronic hepatitis B during immune clearance stage by real time shear wave elastography(SWE).Methods Two hundred and thirteen patients with chronic hepatitis B in immune clearance stage were enrolled in this study.Data of liver elastic modulus was measured by SWE,using pathological results as the golden standard,the corrrelation between the degree of liver fibrosis and elastic modulus was analyzed.The effecacy of diagnosis of liver fibrosis(≥S2 stage)by SWE data was analyzed with ROC curve.Results The elastic modulus of 213 patients with liver fibrosis in stage S0,S1,S2 and S3 ~S4 were(6.73 ± 2.04)k Pa,(7.06 ± 2.60)k Pa,(88.34 ±4.12)k Pa,(12.82 ± 6.63)k Pa,respectively.The differences of elastic modulus among groups were significant(F=22.141,P<0.01).There was a positive correlation between the elastic modulus of liver and the degree of liver fibrosis in the stage of immune clearance(r=0.488,P=0.000).The area under ROC curve in diagnosis of ≥S2 stage liver fibrosis was 0.739,the cutoff value was8.81 k Pa,the sensitivity and specificity were 58.8% and 81.9%,respectively.Conclusion SWE technology provides a reference for the diagnosis of liver fibrosis in patients with chronic hepatitis B,and is helpful for further treatment tragedy and prognosis.

关 键 词：剪切波弹性成像 实时 免疫清除期 乙型肝炎 慢性 肝纤维化 

分 类 号：R575[医药卫生—消化系统] R445.1[医药卫生—内科学]