抗结核药物性肝损伤患者肝脾CT测量值的改变及其临床意义  

Changes and clinical significance of CT measurement of liver and spleen in patients with anti-tuberculosis drug-induced liver injury

作　　者：刘苏娟 梁长华[1] 段金辉 Liu Sujuan;Liang Changhua;Duan Jinhui(Department of Radiology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,China;Department of Magnetic Resonance,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,China)

机构地区：[1]新乡医学院第一附属医院放射科,河南卫辉453100 [2]新乡医学院第一附属医院磁共振科,河南卫辉453100

出　　处：《中国实用医刊》2021年第13期23-26,共4页Chinese Journal of Practical Medicine

摘　　要：目的:分析抗结核药物性肝损伤(ATB-DILI)患者肝脾CT测量值的改变及其临床意义。方法:抽取2020年1月至2020年12月新乡医学院第一附属医院收治的73例ATB-DILI患者作为ATB-DILI组,其中轻度32例,中度25例,重度16例;并以1∶1配比抽取同期健康体检者73例作为健康对照组。ATB-DILI组与健康对照组均行CT诊断,比较两组CT测量值,包括肝CT值、肝与脾差值、肝/脾比值;比较ATB-DILI组中不同病情程度患者的CT测量值、肝功能异常率;比较ATB-DILI组中不同病情程度患者治疗前后肝CT值和肝功能异常率。分析肝脾CT测量值改变和肝功能异常的相关性。结果:ATB-DILI组肝CT值、肝/脾比值低于健康对照组,肝与脾差值高于健康对照组,差异有统计学意义(P<0.05)。ATB-DILI组中,轻度、中度、重度患者肝CT值、肝与脾差值、肝/脾比值比较,差异有统计学意义(P<0.05);重度患者肝CT值、肝/脾比值低于轻度、中度患者,肝与脾差值高于轻度、中度患者,差异有统计学意义(P<0.05)。ATB-DILI重度患者肝功能异常率为43.75%(7/16),高于轻度、中度ATB-DILI患者的6.25%(2/32)、12.00%(3/25),P<0.05。治疗后,轻度、中度、重度患者肝CT值均较治疗前升高,差异有统计学意义(P<0.05);肝功能异常率均较治疗前降低,但轻度、中度、重度患者组间比较差异未见统计学意义(P>0.05)。Pearson分析结果显示,肝CT值和肝功能异常率呈负相关(r=-0.641,P=0.007)。结论:ATB-DILI患者CT测量值呈异常表达,肝CT值、肝/脾比值较低,肝与脾差值较高,并与病情程度、肝功能异常率密切相关,且肝CT值和肝功能异常率呈负相关,临床可据此实施疾病诊疗和预后评估。Objective To analyze the changes and clinical significance of CT measurement of liver and spleen in patients with anti-tuberculosis drug-induced liver injury(ATB-DILI).Methods A total of 73 patients with ATB-DILI treated in the First Affiliated Hospital of Xinxiang Medical University from January 2020 to December 2020 were selected as the ATB-DILI group,including 32 mild cases,25 moderate cases,and 16 severe cases.A total of 73 healthy patients during the same period were selected as the healthy control group according to 1∶1 ratio principle.Computed tomography(CT)was performed for diagnosis in ATB-DILI group and healthy control group.The CT measurement values of the two groups were compared,including the CT value of liver,the difference between liver and spleen,and spleen/spleen ratio.The CT measurement value and abnormal rate of liver function of patients with different disease degrees in ATB-DILI group were compared.The liver CT value and abnormal rate of liver function were compared among them in ATB-DILI group before and after treatment.The correlation of the changes of CT measurement of liver and spleen with abnormal liver function was analyzed.Results The liver CT value and liver/spleen ratio of the ATB-DILI group were lower than those of the healthy control group,and the difference between liver and spleen of the ATB-DILI group was higher than that of the healthy control group(P<0.05).In the ATB-DILI group,there were statistically significant differences in liver CT values,differences between liver and spleen,and liver/spleen ratios in mild,moderate,and severe patients(P<0.05);the liver CT value and liver/spleen ratio of severe patients were lower,and the difference between liver and spleen of severe patients was higher compared with those of mild and moderate patients(P<0.05).The abnormal liver function rate of patients with severe ATB-DILI was 43.75%(7/16),higher than 6.25%(2/32)of mild patients and 12.00%(3/25)of moderate patients in ATB-DILI group(P<0.05).After treatment,liver CT values of mild,mode

关 键 词：肝 抗结核药物性肝损伤 CT测量值 肝功能异常率 相关性分析 影像学表现 

分 类 号：R575[医药卫生—消化系统]