肝脏组织硬度与慢性乙型肝炎患者肝组织纤维化的相关性研究及诊断效能分析  

Study on the correlation and analysis of diagnostic efficacy between liver tissue stiffness and liver fibrosis in patients with chronic hepatitis B

作　　者：曾箭云 刘艳华 钟志民 钟启盛 ZENG Jianyun;LIU Yanhua;ZHONG Zhimin;ZHONG Qisheng(Department of Electrical Science,Xingguo Affiliated Hospital of Gannan Medical University,Jiangxi Province,Xingguo342400,China;Department of Imaging,Xingguo Affiliated Hospital of Gannan Medical University,Jiangxi Province,Xingguo342400,China;Department of Infectious Diseases,Xingguo Affiliated Hospital of Gannan Medical University,Jiangxi Province,Xingguo342400,China)

机构地区：[1]赣南医学院附属兴国医院电生理科,江西兴国342400 [2]赣南医学院附属兴国医院影像科,江西兴国342400 [3]赣南医学院附属兴国医院感染疾病科,江西兴国342400

出　　处：《中国当代医药》2023年第35期49-52,56,共5页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目(GZ2021ZSF 695)。

摘　　要：目的探析肝脏组织硬度与慢性乙型肝炎(简称“乙肝”)患者肝组织纤维化的关系,并分析肝脏组织硬度在慢性乙肝患者肝组织纤维化中的诊断价值。方法选取2021年5月至2022年5月赣南医学院附属兴国医院收治的156例慢性乙肝患者,利用声辐射力脉冲弹性成像(ARFI)技术检测156例慢性乙肝患者以及同期40例健康人群肝脏组织硬度,并化验肝功能、血常规,计算天冬氨基酸转氨酶/血小板比值指数(APRI),将病检结果作为金标准,分析肝脏组织硬度与APRI、肝纤维化病理分期的相关性,并分析肝脏组织硬度在慢性乙肝患者肝组织纤维化中的诊断价值。结果肝脏组织硬度测量值成功率<60%的数据定义为无效测量数值。健康组40例均为有效测量数据;156例慢性乙肝患者中有23例肝脏组织硬度测量值为无效数据。随着肝纤维化程度的加重,肝脏组织硬度以及APRI值随之相应升高,差异有统计学意义(P<0.05)。肝脏组织硬度分别与病理纤维化分期、APRI呈正相关,差异有统计学意义(r=0.589、0.482,P<0.05)。肝脏组织硬度诊断肝纤维化S_(0)期与S_(1)~S_(4)期、S_(0)~S_(1)期与S_(2)~S_(4)期、S_(0)~S_(2)期与S_(3)~S_(4)期、S_(0)~S_(3)期与S_(4)期的曲线下面积(AUC)分别为0.739、0.771、0.760、0.759,肝脏组织硬度对肝纤维化各期均有良好的诊断效能,差异有统计学意义(P<0.05),其中诊断S_(0)~S_(1)期与S_(2)~S_(4)期的AUC最大为0.771,诊断价值最高,差异有统计学意义(P<0.05)。结论肝脏组织硬度以及APRI均能够反映慢性乙肝患者肝组织纤维化的情况,且肝脏组织硬度在慢性乙肝患者肝组织纤维化的诊断中具有较高的诊断价值。Objective To explore the relationship between liver tissue stiffness and liver fibrosis in chronic hepatitis B patients,and analyze the diagnostic value of liver tissue stiffness in chronic hepatitis B patients with liver fibrosis.Methods A total of 156 patients with chronic hepatitis B admitted to Xingguo Affiliated Hospital of Gannan Medical University from May 2021 to May 2022 were selected.The liver tissue stiffness of 156 patients with chronic hepatitis B and 40 healthy people as the same time were detected by acoustic radiation force impulse(ARFI)elastography technology,and the liver function and blood routine tests were conducted to calculate the aspartate amino acid transaminase/platelet ratio index(APRI).The correlation between liver tissue stiffness,APRI and the pathological stage of liver fibrosis was analyzed by taking the results of disease examination as the gold standard.The diagnostic value of liver tissue stiffness in hepatic fibrosis of chronic hepatitis B patients was analyzed.Results The success rate of liver stiffness measurement<60%was defined as invalid measurement value.All the 40 cases in the healthy group were valid data.In the 156 patients with chronic hepatitis B,23 of the liver tissue stiffness measurements were invalid.With the aggravation of liver fibrosis,liver tissue stiffness and APRI value increased correspondingly,and the differences were statistically significant(P<0.05).Liver tissue stiffness was positively correlated with pathological fibrosis stage and APRI,and the differences were statistically significant(r=0.589,0.482,P<0.05).The area under curve(AUC)of S_(0)and S_(1)-S_(4)stages,S_(0)-S_(1)and S_(2)-S_(4)stages,S_(0)-S_(2)and S_(3)-S_(4)stages,S_(0)-S_(2)and S_(0)-S_(3)and S_(4)stages were 0.739,0.771,0.760 and 0.759,respectively,and liver hardness had good diagnostic efficacy for each stage of liver fibrosis.The differences were statistically significant(P<0.05),and the AUC of S_(0)-S_(1)and S_(2)-S_(4)stages were the highest,with the highest diagnostic value,and the d

关 键 词：肝脏组织硬度 肝纤维化 弹性成像技术 天冬氨基酸转氨酶/血小板比值指数 

分 类 号：R575[医药卫生—消化系统]