SWE技术在慢性乙型肝炎肝纤维化评估中的应用价值  

Application Value of SWE Technique in the Evaluation of Hepatic Fibrosis in Chronic Hepatitis B

作　　者：秦文娟 邵孝 李可兴 QIN Wen-juan;SHO Xiao;LI Ke-xing(Department of Ultrasound,Gongyi City People's Hospital,Zhengzhou 451299,Henan Province,China)

机构地区：[1]巩义市人民医院超声科,河南郑州451299

出　　处：《罕少疾病杂志》2024年第8期72-74,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨慢性乙型肝炎肝纤维化患者实施剪切波弹性成像(SWE)技术的诊断效果。方法选取慢性乙型肝炎患者88例,选取时间为2022年7月至2023年1月,所有患者均来源于巩义市人民医院,均进行SWE超声检查,并进行肝活检,对血清学指标进行检测,计算APRI、FIB-4。将非显著与显著性纤维化患者的临床资料进行对比,将临床资料中有统计学意义因素进行进一步分析,采用ROC分析各指标的诊断价值。结果采用肝脏穿刺活体组织检查术发现,88例患者中,肝纤维化F0、F1、F2、F3、F4期的患者分别为9、25、28、14、12例。非显著性和显著性肝纤维化的患者分别为34、54例。显著性肝纤维化组患者杨氏模量值、透明质酸(HA)等指标水平均相较于非显著性肝纤维化组高(均P<0.05);对影响慢性乙型肝炎患者显著性肝纤维化的因素进行筛选发现,危险因素包括杨氏模量值、APRI、FIB-4(OR=4.190、3.807、1.230,均P<0.05);ROC曲线分析显示,杨氏模量值在诊断慢性乙型肝炎患者显著性肝纤维化中,其曲线下面积(AUC)比APRI、FIB-4大(P<0.05)。结论慢性乙型肝炎临床诊断中,应用SWE技术检测杨氏模量值可对肝纤维化病情进行有效评估,临床价值较高。Objective To investigate the value of shear wave elastography(SWE)in the evaluation of hepatic fibrosis in chronic hepatitis B.Methods A total of 88 patients with chronic hepatitis B were included,and the selected time was from July 2022 to January 2023.All patients were from Gongyi People's Hospital.All patients were examined by SWE ultrasonic diagnostic instrument and underwent liver biopsy to detect serological indexes.The index of glutamic oxalacetic transaminase/platelet ratio(APRI)and liver fibrosis-4 factor index(FIB-4)were calculated.The clinical data of patients with non-significant and significant fibrosis were compared,and the statistically significant factors in the clinical data were further analyzed,and the diagnostic value of each indicator for significant liver fibrosis in patients with chronic hepatitis B was analyzed by operating characteristic curve(ROC).Results Among 88 patients,9,25,28,14 and 12 patients with F0,F1,F2,F3 and F4 stages of liver fibrosis were found by liver biopsy.There were 34 patients with non-significant hepatic fibrosis.There were 54 patients with significant hepatic fibrosis.The levels of Young's modulus and hyaluronic acid(HA)in significant hepatic fibrosis group were higher than those in non-significant hepatic fibrosis group(all P<0.05).The risk factors of significant liver fibrosis in chronic hepatitis B patients were Young's modulus,APRI,FIB-4(OR=4.190,3.807,1.230,all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of Young's modulus was larger than that of APRI and FIB-4 in diagnosing significant liver fibrosis in patients with chronic hepatitis B(P<0.05).Conclusion The application of SWE technique to detect Young's modulus can effectively evaluate the hepatic fibrosis of chronic hepatitis B and has high clinical value.

关 键 词：剪切波弹性成像 慢性乙型肝炎 肝纤维化 评估 价值 

分 类 号：R575.2[医药卫生—消化系统]