超声弹性成像评估肝移植术后稳定状态受者不同时期肝脏弹性的应用价值  

Application value of ultrasound elastography in evaluating liver elasticity of stable recipients at different stages after liver transplantation

作　　者：李沁园 姜伟 冯程 赵宁波 王新发 董常峰[3] Li Qinyuan;Jiang Wei;Feng Cheng;Zhao Ningbo;Wang Xinfa;Dong Changfeng(Guangdong Medical University,Zhanjiang 524000,China)

机构地区：[1]广东医科大学,广东湛江524000 [2]华中科技大学协和深圳医院超声科 [3]深圳市第三人民医院超声科

出　　处：《器官移植》2021年第1期103-108,共6页Organ Transplantation

基　　金：国家自然科学基金面上项目(61031003)。

摘　　要：目的探讨超声弹性成像技术无创性监测肝移植术后稳定状态受者不同时期肝脏弹性的价值。方法收集73例肝移植术后稳定状态受者的临床资料,根据肝移植术后时间分为早期组(25例)和中长期组(48例),同时选取38名健康体检者作为对照组。比较各组研究对象的超声指标和肝功能指标;分析各组研究对象的肝脏和脾脏弹性成像指标,并分析其与肝功能指标的相关性。结果与对照组比较,早期组的各项超声指标和丙氨酸转氨酶(ALT)、γ-谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)升高,差异均有统计学意义(均为P<0.05),中长期组的各项超声指标升高,GGT降低,差异均有统计学意义(均为P<0.05);与早期组比较,中长期组的肝脏右斜径和ALT、GGT、ALP降低,差异均有统计学意义(均为P<0.05)。与对照组比较,早期组和中长期组肝脏声触诊弹性成像(STE)值、声触诊弹性测量(STQ)值与脾脏STE值均升高,差异均有统计学意义(均为P<0.05);与早期组比较,中长期组的肝脏和脾脏弹性成像指标均降低,差异均有统计学意义(均为P<0.05)。肝脏弹性成像指标与ALT、天冬氨酸转氨酶(AST)、GGT呈弱相关性,与ALP呈强相关性。脾脏STE值与ALP呈弱相关性。肝脏STE值与肝脏STQ值呈强相关性,肝脏STE值、STQ值与脾脏STE值均呈弱相关性。结论肝移植术后稳定状态受者不同时期的肝脏弹性特征不同,持续监测肝脏弹性可能为肝移植术后随访提供全新的无创性监测方式。Objective To explore the value of ultrasound elastography in the non-invasive monitoring of liver elasticity of stable recipients at different stages after liver transplantation.Methods Clinical data of 73 stable recipients after liver transplantation were collected.According to the time after liver transplantation,all patients were divided into the early group(n=25)and medium-to-long group(n=48).In addition,38 healthy subjects were assigned into the control group.The ultrasound indexes and liver function indexes were statistically compared among each group.The ultrasound elastography indexes of liver and spleen were analyzed,and their correlation with liver function indexes was analyzed.Results Compared with the control group,the ultrasound indexes,alanine aminotransferase(ALT),γ-glutamyl transferase(GGT)and alkaline phosphatase(ALP)levels were significantly increased in the early group(all P<0.05),and the ultrasound indexes in the medium-to-long group were significantly increased,whereas the GGT level was significantly decreased(all P<0.05).Compared with the early group,the right oblique diameter of liver,ALT,GGT and ALP levels were significantly decreased in the medium-to-long group(all P<0.05).Compared with the control group,the sound touch elastography(STE)and sound touch quantify(STQ)values of liver and STE value of spleen in the early group and medium-to-long group were significantly increased(all P<0.05).Compared with the early group,the ultrasound elastography indexes of liver and spleen in the medium-to-long group were remarkably decreased(all P<0.05).The ultrasound elastography indexes of liver were weakly correlated with the ALT,aspartate aminotransferase(AST)and GGT levels,significantly correlated with ALP level.The STE value of spleen was weakly correlated with the ALP level.The STE value of liver was significantly correlated with the STQ value of liver.The STE and STQ values of liver were weakly correlated with the STE value of spleen.Conclusions The characteristics of liver elasticity in stable r

关 键 词：肝移植 声触诊弹性成像(STE) 声触诊弹性测量(STQ) 丙氨酸转氨酶 天冬氨酸转氨酶 总胆红素 Γ-谷氨酰转移酶 碱性磷酸酶 

分 类 号：R617[医药卫生—外科学] R445.1[医药卫生—临床医学]