二维实时剪切波弹性成像与血清微小核糖核酸-122评估乙型肝炎患者肝纤维化的作用  

Diagnostic value of real-time two-dimensional shear wave elastography and serum microRNA-122 levels in evaluating the liver fibrosis of patients with hepatitis B

作　　者：王立美 张玉卓 李洁[1] 谷培 秘景慧 WANG Limei;ZHANG Yuzhuo;LI Jie(Shijiazhuang People’s Hospital,Hebei,Shijiazhuang 050031,China)

机构地区：[1]河北省石家庄市人民医院,050031 [2]河北省中医药科学院

出　　处：《河北医药》2022年第19期2929-2931,2935,共4页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展指导计划(编号:181461123)。

摘　　要：目的研究二维实时剪切波弹性成像与血清微小核糖核酸-122(miRNA-122)评估乙型肝炎患者肝纤维化的诊断价值。方法选取2019年10月至2022年2月收治的80例乙型肝炎患者为研究对象,根据肝纤维化分期进行分组。另选取同期60例健康体检者为对照组,2组均接受二维实时剪切波弹性成像检查以及血清微小核糖核酸-122检测。比较2组研究对象的肝脏硬度测定值(liver stiffness measurement,LSM)以及血清miRNA-122指标,分析二维实时剪切波弹性成像与血清微小核糖核酸和肝纤维化的相关性。结果S0组与对照组LSM值差异无统计学意义(P>0.05);S1、S2、S3、S4组LSM值均显著高于对照组,S4组显著高于S0、S1、S2、S3组,S3组显著高于S0、S1、S2组,S2组显著高于S0、S1组,S1组显著高于S0组,差异有统计学意义(P<0.05)。观察组中S0、S1、S2组肝纤维化(轻中度纤维化)患者血清miRNA-122水平比S3、S4组(重度纤维化)患者显著增高(P<0.05)。经过相关性分析得出,二维实时剪切波弹性成像与肝纤维化分期呈正相关。以活检穿刺病理结果为金标准,各个观察组分期AUC结果分别为0.800、0.791、0.774、0.814,≥S1阈值为80.61,≥S2阈值为88.39,≥S3阈值为90.77,s4阈值为94.59。以活检穿刺病理结果为金标准,各个观察组分期血清miR-122的AUC结果分别为0.795、0.782、0.761、0.802,≥S1最佳界值为80.61,≥S2最佳界值为88.39,≥S3最佳界值为90.77,S4最佳界值为3.483。结论二维实时剪切波弹性成像与血清miRNA-122水平能够有效判断乙肝患者的肝纤维化程度。Objective To investigate the diagnostic value of Diagnostic value of real-time two-dimensional shear wave elastography(RT 2D-SWE)and serum microRNA-122(miR-122)levels in evaluating the liver fibrosis of patients with Hepatitis B(HB).Methods Eighty HB patients visited in our hospital from October 2019 to February 2022 were enrolled assigned into different groups(observation group)according to the stages of liver fibrosis.At the same time,the other 60 persons receiving health examination were as control group,the detection of RT 2D-SWE and serum miR-122 were conducted in the both groups.The key observation was intergroup liver stiffness measurement(LSM)and miR-122 index,as well as the correlation between the two indexes.Results There was no significant difference in the LSM values??between the S0 group and the control group(P>0.05);the LSM values in the S1,S2,S3,and S4 groups were significantly higher than those in the control group,and the S4 group was significantly higher than the S0,S1,S2,and S3 groups,S3 group was significantly higher than S0,S1,S2 group,S2 group was significantly higher than S0,S1 group,S1 group was significantly higher than S0 group(all P<0.05).Serum miR-122 levels in patients with mild to moderate fibrosis of S0,S1,S2 groups were significantly higher than those in patients with severe fibrosis of S3,S4 groups(P<0.05).Correlation analysis showed that RT 2D-SWE was positively correlated with liver fibrosis stage.Taking biopsy results as the gold standard,the AUC results of S1,S2,S3,S4 group were 0.800,0.791,0.774,and 0.814,respectively;the threshold were 80.61,88.39,90.77,94.59 for≥S1,≥S2,≥S3,≥S4,respectively;the AUC results of serum miR-122 in each observation group were 0.795,0.782,0.761,and 0.802,respectively.The optimal threshold for≥S1 of 80.61,for≥S2 of 88.39,for≥S3 of 90.77,for S4 of 3.483,respectively.Conclusion RT 2D-SWE and miR-122 level can effectively evaluate the liver fibrosis degree of HB patients.

关 键 词：乙型肝炎 肝纤维化 实时剪切波弹性成像 血清核糖核酸-122 

分 类 号：R445.1[医药卫生—影像医学与核医学]