声触诊弹性成像在非酒精性脂肪性肝病合并慢性乙型肝炎诊断中的应用价值  

Application value of sound touch elastography in diagnosing nonalcoholic fatty liver disease complicated with chronic hepatitis B

作　　者：李晓慧 曾伟梅 董常峰[1] 郑保奇 陈昕[2] 刘忠 Li Xiaohui;Zeng Weimei;Dong Changfeng;Zheng Baoqi;Chen Xin;Liu Zhong(Department of Ultrasound,Shenzhen Third People's Hospital,Guangdong Shenzhen 518112,China;School of Biomedical Engineering,Shenzhen University,Guangdong Shenzhen 518000,China)

机构地区：[1]深圳市第三人民医院超声科,广东深圳518112 [2]深圳大学生物医学工程学院,广东深圳518000

出　　处：《新发传染病电子杂志》2024年第4期29-33,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：国家自然科学基金重大科研仪器研制项目(82327804);深圳市第三人民医院院内项目(G2022018)。

摘　　要：目的探讨声触诊弹性成像(sound touch elastography,STE)诊断非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)合并慢性乙型肝炎(chronic hepatitis B,CHB)的价值,明确STE分期诊断NAFLD合并CHB患者肝纤维化程度的效能。方法选取2018年1月至2023年1月在深圳市第三人民医院肝病科就诊的NAFLD患者74例和NAFLD合并CHB患者142例,分别纳入NAFLD组、NAFLD合并CHB组。选取健康志愿者61例,纳入对照组。NAFLD合并CHB组患者根据METAVIR肝纤维化分级标准分为S1期、S2期、S3期、S4期。所有受试者均接受肝STE、肝声触诊定量(sound touch quantify,STQ)检查,比较三组间肝弹性测值有无差异,绘制受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)。结果三组间肝硬度值(liver stiffness measurement,LSM)、肝STE、肝STQ有统计学差异(P<0.001)。肝STE、肝STQ区分对照组与NAFLD合并CHB组的ROC曲线下面积(under the curve,AUC)为0.834、0.805;区分对照组与NAFLD组的AUC为0.628、0.617;区分NAFLD合并CHB组与NAFLD组的AUC为0.741、0.715。肝STE诊断NAFLD合并CHB组≥S1、≥S2、≥S3期肝纤维化和S4期肝硬化的AUC分别为0.834、0.889、0.940、0.950。结论NAFLD合并CHB时,肝脏STE、STQ值较NAFLD患者及正常人群升高。肝STE在分期诊断NAFLD合并CHB患者肝纤维化程度方面具备显著价值。Objective To explore the value of sound touch elastography(STE)in diagnosing nonalcoholic fatty liver disease(NAFLD)complicated with chronic hepatitis B(CHB)and identifying the Diagnostic efficacy of STE for staging the degree of liver fibrosis in this combination.Method A total of 74 NAFLD patients and 142 NAFLD patients complicated with CHB who were selected from January 2018 to January 2023 were included in the NAFLD group and NAFLD complicated with CHB group,respectively.NAFLD complicated with CHB group were classified as stage S1,stage S2,stage S3,and stage S4 according to the METAVIR grading criteria.61 healthy volunteers were selected and included in the control group.All subjects accepted liver STE and liver STQ examinations.Compare the three groups and draw the receiver operator characteristic curve(ROC).Result There was significant difference in liver STE and liver STQ among the three groups(P<0.001).The area under the curve(AUC)of liver STE and liver STQ between control group and NAFLD complicated with CHB group was 0.834 and 0.805,the AUC between control group and NAFLD group was 0.628 and 0.617,and the AUC between NAFLD complicated with CHB group and NAFLD group was 0.741 and 0.715.The AUC of liver STE in diagnosing NAFLD complicated with CHB≥S1,≥S2,≥S3 liver fibrosis and S4 cirrhosis were 0.834,0.889,0.940,0.950 respectively.Conclusion There were differences in liver stiffness measurement(LSM)among NAFLD complicated with CHB,NAFLD and normal liver.Liver STE can distinguish NAFLD complicated with CHB Group from control group and NAFLD group,it has great value in the diagnosis of liver fibrosis in patients suffered NAFLD complicated with CHB.

关 键 词：非酒精性脂肪性肝病 慢性乙型肝炎 声触诊弹性成像 声触诊定量 

分 类 号：R512.91[医药卫生—内科学]