多模态超声及生化指标对原发性胆汁性胆管炎患者病理学分期的预测价值  

The Value of Multimodal Ultrasound and Biochemical Indicators in Pathological Stage Prediction of Patients with Primary Biliary Cholangitis

作　　者：王雪梅 张瑶[1] 王米雪 王跃龙 王玥[1] Wang Xuemei;Zhang Yao;Wang Mixue;Wang Yuelong;Wang Yue(Department of Ultrasound,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院超声科,北京市100015

出　　处：《中国超声医学杂志》2024年第8期902-904,共3页Chinese Journal of Ultrasound in Medicine

基　　金：首都医科大学附属北京地坛医院院内科研基金(No.DTQH202107)。

摘　　要：目的分析原发性胆汁性胆管炎(PBC)患者不同病理分期血生化、超声指标的差异,为无创评估PBC患者分期提供依据。方法回顾性分析PBC62例患者的资料,根据病理分为早期(≤Ⅱ期)42例、进展期(>Ⅱ期)20例,比较两组血生化指标[总胆红素(TBIL)、血小板计数(PLT)等]、肝脏超声图像、脾厚径(ST)、脾长径(SD)及肝脏硬度(LSM),构建受试者工作特征曲线,计算曲线下面积(AUC),根据约登指数最高临界点确定截断值。结果两组血生化(TBIL、PLT)、超声(ST、SD、LSM)指标比较差异有统计学意义(P<0.05)。早期肝脏超声表现为正常肝或肝脏弥漫性病变,进展期以肝脏弥漫性病变和肝硬化为主;LSM、ST与SD诊断PBC患者进展期曲线下面积(AUC)分别为0.846、0.699、0.736;截断值分别为10.5kPa、35.2mm、120mm;灵敏度(Se)分别为100%、80.0%、75.0%;特异度(Sp)分别为64.3%、60.5%、76.7%。结论临床可根据多模态超声及生化指标综合评估PBC患者疾病进展情况,为治疗方案制订提供无创诊断参考依据。Objective To analyze the differences of biochemical and ultrasound indicators between different pathological stages of primary biliary cholangitis(PBC)patient,and provide reference for non-invasive evaluation of stage in PBC patient.Methods Retrospective analysis of 62 PBC patients.They were divided into two groups based on pathological stage,with 42 cases in the early stage(≤Ⅱstage)and 20 cases in the advanced stage(>Ⅱstage).The biochemical indicators total bilirubin(TBIL),platelet count(PLT),etc.J,liver ultrasound images,spleen thickness(ST),spleen diameter(SD),and liver stiffness measurement(LSM)were compared between the two groups.Construct a receiver operating characteristic(ROC)curve,calculate the area under the curve(AUC),and determine the cutoff value based on the highest critical point of the Jordan index.Results The difference in serum indicators(TBIL,PLT)and ultrasound(ST,SD,LSM)between the two groups was statistically significant(P<0.05).The mainly feature of liver ultrasound imaging in early stage patients was coarse liver parenchyma echo or diffuse liver lesion,while in the advanced stage,diffuse liver lesion and cirrhosis were the main manifestations.The advanced AUC of PBC patients diagnosed by LSM,ST,and SD were 0.846,0.699,and 0.736;The cutoff values were 10.5 kPa,35.2 mm,and 120 mm;The sensitivity(Se)was 100%,80.0%,and 75.0%;The specificity(Sp)were 64.3%,60.5%,and 76.7%.Conclusions The disease progression of PBC patients can be comprehensively evaluated based on multimodal ultrasound and biochemical indicators,providing non-invasive diagnostic reference for the formulation of treatment plans.

关 键 词：原发性胆汁性胆管炎 超声 肝硬度 弹性成像技术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.7[医药卫生—诊断学]