瞬时弹性成像技术对乙肝及自身免疫性肝病诊断效能对比分析
Comparative study of transient elastography in the diagnosis of hepatitis B and autoimmune liver disease
王国英 1宋彦莉 2刘超 3李培 4王敏5
作者信息
- 1. 河北省邯郸市传染病医院功能科 河北 邯郸 056000
- 2. 河北省秦皇岛市第二医院消化科 河北 秦皇岛 066600
- 3. 河北省邯郸市中心医院消化内科 河北 邯郸 056000
- 4. 河北省正定县人民医院超声科 河北 石家庄 050800
- 5. 河北省行唐县人民医院超声科 河北 石家庄 050600
- 折叠
摘要
目的 探讨瞬时弹性成像技术(fibrotouch,FT)对乙型肝炎及自身免疫性肝病诊断效能对比价值.方法 选取我院收治的乙型肝炎患者 59 例(A组)、原发性胆汁性胆管炎患者 31 例(B组),两组均接受肝组织穿刺病理检查,获取患者病理纤维化程度分期;分别对两组进行FT检查,获得两组患者的肝硬度值(LSM),尝试分析患者LSM与病理纤维化分期的关联及差异.结果 两组患者的肝细胞炎症程度、肝组织纤维化变化基本趋于一致,Pearson分析结果显示,炎症、纤维化程度呈正相关(P<0.05);两组无纤维化、轻中度、重度纤维化患者的肝硬度值呈上升趋势,病理分期越严重,LSM越大,且不同病理分期LSM差异有统计学意义(t=234.599,321.819;均P<0.001);两组患者LSM:A组无纤维化、中轻度及重度纤维化患者LSM均低于B组,其中S0 分期差异无统计学意义(t=1.780;P=0.079);S1～S2、S3～S4 分期差异具有统计学意义(t=8.352,6.392;P<0.001).结论 FT为无创、定量评估肝病患者肝脏纤维化程度的有效方式,为临床诊治提供科学依据;肝纤维化程度越高则FT检查提示LSM越高;同一病理分期下,乙型肝炎、原发性胆汁性胆管炎患者LSM存在差异;后续可尝试构建不同类型肝炎患者FT检查肝脏损伤程度参考标准.
Abstract
Objective To explore the comparative value of transient elastography(FT)in the diagnosis of hepatitis B and au-toimmune liver disease.Methods A total of 59 patients with hepatitis B(Group A)and 31 patients with primary biliary cholan-gitis(Group B)admitted to our hospital were selected.Patients of both groups underwent liver biopsy and pathological examina-tion to obtain the stages of fibrosis;FT examination was performed on patients of two groups to obtain the liver stiffness value(LSM)of patients of the two groups,and an attempt was made to analyze the correlation and difference between the liver stiff-ness value and the stage of pathological fibrosis.Results The degree of hepatocyte inflammation and liver fibrosis in patients of the two groups tended to be consistent.Pearson analysis showed that there was a positive correlation between the degree of inflam-mation and fibrosis(P<0.05);The liver hardness values of patients with no fibrosis,mild to moderate,and severe fibrosis in the two groups showed an upward trend.The more severe the pathological stage was,the greater the LSM was,and the difference in LSM among different pathological stages was statistically significant(t=234.599,321.819 both P<0.001);LSM of patients with-out fibrosis,moderate to mild and severe fibrosis in Group A was lower than that in Group B,with no statistically significant dif-ference in S0 stage(t=1.780;P=0.079);The difference between S1～S2 and S3～S4 stages was statistically significant(t=8.352,6.392;P<0.001).Conclusion FT is an effective noninvasive and quantitative method for assessing the degree of liver fibrosis in patients with liver diseases,providing scientific basis for clinical diagnosis and treatment;The higher the degree of liver fibro-sis,the higher the LSM is indicated by FT examination;Under the same pathological stage,there are differences in LSM be-tween patients with hepatitis B and primary biliary cholangitis;In the future,we can try to establish a reference standard for liver damage in FT examination of patients with different types of hepatitis.
关键词
瞬时弹性成像技术/乙型肝炎/病理纤维化分期/超声检查Key words
Instantaneous elastic imaging technology/Hepatitis B/Staging of pathological fibrosis/Ultrasound引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据