SWE定量评估孕妇胆汁淤积综合征的临床价值  

The clinical value of real-time shear wave elastography in quantitative evaluation of bile acid stasis syndrome in pregnant women

作　　者：刘红[1] 冯国隽[1] 黄兰英[2] 赵小东[1] LIU Hong;FENG Guojun;HUANG Lanying;ZHAO Xiaodong(Ultrasound Medicine Department,Jiangyou People's Hospital,Mianyang 621700,Sichuan,China;Laboratory Department,Jiangyou People's Hospital,Mianyang 621700,Sichuan,China)

机构地区：[1]江油市人民医院超声医学科,四川江油621700 [2]江油市人民医院检验科,四川江油621700

出　　处：《中南医学科学杂志》2024年第5期819-822,共4页Medical Science Journal of Central South China

基　　金：四川省卫计委课题项目(16PJ400);绵阳市卫生健康委员会课题(202157)。

摘　　要：目的 探讨实时剪切波弹性成像(SWE)定量评估孕妇胆汁淤积综合征(CS)的临床价值。方法 选择本院就诊的CS孕妇121例(CS组)及正常孕妇115例(对照组)。比较两组一般资料及胆汁酸、谷丙转氨酶、谷草转氨酶、总胆红素、直接胆红素水平;ROC分析SWE对孕妇胆汁淤积综合征的诊断效能。结果 CS组孕周、肝脏弹性值、胆汁酸、谷丙转氨酶、谷草转氨酶、总胆红素、直接胆红素均高于对照组(P<0.05)。控制了年龄、孕周、谷丙转氨酶、谷草转氨酶、总胆红素及直接胆红素之后,肝脏弹性值每增大1 kPa,CS风险增加7.966倍。肝脏弹性值诊断CS的ROC下面积为0.910(0.873,0.946),最佳分界点为肝脏弹性值6.44 kPa,此时的灵敏度和特异度分别为75.7%和96.7%,约登指数为0.724。结论 实时剪切波弹性成像能够在早期准确、无创评估孕妇胆汁淤积综合征的肝脏情况,对CS的早期诊断、治疗和干预有较高的临床价值。Aim To explore the clinical value of real-time shear wave elastography(SWE) in quantitative assessment of cholestasis syndrome(CS) in pregnant women.Methods 121 cases of pregnant women with CS(CS group) and 115 cases of normal pregnant women(control group) were selected.General data,bile acids,alanine aminotransferase,aspartate aminotransferase,total bilirubin,and direct bilirubin,in the two groups were compared;ROC curve was used to analyze the diagnostic efficacy of SWE on choleacidosis syndrome in pregnant women.Results The gestational age,liver elasticity value,bile acids,alanine aminotransferase,aspartate aminotransferase,total bilirubin,and direct bilirubin in CS group were significantly higher than control group(P<0.05).After controlling the age,gestational period,glutamate aminotransferase,aspartate aminotransferase,total bilirubin and direct bilirubin,the risk of CS increased 7.966 times with every 1 unit increase in liver elasticity.The area under the ROC curve for liver elasticity value diagnosis of CS is 0.910(0.873,0.946).The optimal cut-off point is liver elasticity value greater than 6.44.At this time,the sensitivity and specificity are 75.7% and 96.7% respectively,and the Youden index is 0.724.Conclusion Real-time shear wave elastography can accurately and non-invasively assess the liver condition of pregnant women with cholestasis syndrome at an early stage,and has high clinical value for early diagnosis,treatment and intervention of CS.

关 键 词：实时剪切波弹性成像 孕妇 胆汁淤积综合征 

分 类 号：R575[医药卫生—消化系统]