摘要
目的:探讨声脉冲辐射力(acoustic radiation force impulse,ARFI)成像技术定量参数剪切波速度和实验室血清总胆汁酸在慢性丙型肝炎肝硬化患者中的特点,以及二者与肝功能Child-Pugh分级的关系.方法:连续收集临床已确诊为慢性丙型肝炎肝硬化患者86例,根据临床指标,对86例患者进行肝功能Child-Pugh分级.测量肝脏剪切波速度(shear wave velocity,SWV)和血清总胆汁酸(total bile acid,TBA),记录相关数据进行分析.同时,选择30例健康志愿者作为对照组,分别测量肝脏SWV值以及血清TBA与研究组进行对照研究.结果:86例患者中男40例,女46例,平均年龄为56岁±11.2岁,平均SWV值为2.44 m/s±0.39 m/s,平均TBA值为27.2μmol/L±29.7μmol/L;性别、年龄在Child-Pugh A、B、C三个级别患者中差异无统计学意义;研究组S W V值与T B A值均高于对照组,差异具有统计学意义(P<0.05),SWV值与TBA值在Child-Pugh A、B、C 3个级别患者中的平均值分别为2.34 m/s±0.33 m/s,14.6μmol/L±13.8μmol/L;2.39 m/s±0.39 m/s,35.6μmol/L±36.5μmol/L;2.76 m/s±0.34 m/s,38.9μmol/L±31.8μmol/L,在三个级别中差异均有统计学意义(P<0.05).SWV值及TBA值与ChildPugh分级具有较好的相关性,随着ChildPugh级别的升高,SWV值及TBA值均呈上升趋势,且在诊断肝硬化中均具有较好的敏感性,而ROC曲线下面积所得SWV值更高.结论:肝脏S W V值及血清T B A值与肝功能Child-Pugh分级具有良好的相关性,可以作为临床Child-Pugh分级的有效补充,达到更好的评价肝脏储备功能的目标,具有一定的临床应用价值.
AIM： To explore the characteristics of the shear wave velocity （SWV） of acoustic radiation force impulse （ARFI） and serum total bile acids （TBAs） in patients with chronic hepatitis C cirrhosis, and to analyze their relations with Child-Pugh grade. METHODS： Eighty-six patients diagnosed with chronic hepatitis C cirrhosis were enrolled in this study. According to the biochemical indexes and clinical manifestations, Child- Pugh scoring was performed; Liver SWV and serum TBAs were measured and analyzed. Thirty healthy volunteers were chosen as a control group, and their SWV and serum TBAs were studied and compared with those in the study group. RESULTS： The mean age of the patients was 56 ± 11.2, and there were 40 males and 46 females. Mean SWV was 2.44 m/s±0.39 m/s, and mean TBAs were 27.2μmol/L ± 29.7μmol/L. There were no statistical significances in gender or age among patients with Child- Pugh A, B or C liver function. The SWV and TBAs values were significantly higher in the study group than in the control group （P 〈 0.05）. The mean value of SWV and TBAs in patients with Child-Pugh A, B and C liver function were 2.34 m/s±0.33 m/s and 14.6μmol/L±13.8μmol/L; 2.39 m/s ± 0.39 m/s and 35.6 μmol/L ± 36.5μmol/L; 2.76 m/s ± 0.34 m/s and 38.9μmol/L ±31.8μmol/L, respectively. The differences in SWV andTBAs were statistically significant in patients with Child-Pugh A, B and C liver function （P 〈 0.05）. SWV and TBAs had good correlations with Child-Pugh grade, and increased with the increase in Child-Pugh grade. SWV and TBAs have a high sensitivity in the diagnosis of liver cirrhosis, and the area under the ROC curve of SWV was larger than that of TBAs. CONCLUSION： SWV of the liver and TBAs in serum have good correlation with hepatic Child-Pugh grade. SWV and TBA can serve as an effective supplement for Child-Pugh grading, to better evaluate the liver functional reserve.
出处
《世界华人消化杂志》
CAS
2016年第2期287-292,共6页
World Chinese Journal of Digestology
