摘要
目的:观察肝脏彩超半定量分析在预测乙肝患者抗病毒治疗期间终点事件的价值,以指导未来乙肝抗病毒治疗期间不良预后风险的预测。方法:选取在医院就诊且接受抗病毒治疗的80例慢性乙肝患者,按终点事件发生情况将其分为研究组(30例)和对照组(50例),研究组均发生肝硬化、肝癌等终点事件,对照组未发生终点事件。所有患者均接受肝脏彩色多普勒超声检查,比较两组基线资料、肝脏彩超常规结果及半定量分析评分,分析半定量评分与各肝脏彩超指标相关性,评价半定量评分预测终点事件的价值。结果:研究组半定量超声评分高于对照组、肝大小指数低于对照组、门静脉内径大于对照组、门静脉血流速度低于对照组,差异均有统计学意义(t=7.232,t=4.329,t=8.550,t=7.840;P<0.05);慢性乙肝患者超声半定量评分与肝大小指数、门静脉血流速度均呈负相关(r=-0.403,r=-0.573;P<0.05),与门静脉内径呈正相关(r=0.362,P<0.05);绘制受试者工作特征(ROC)曲线,得到超声半定量评分预测终点事件的ROC曲线下面积(AUC)为:0.814(95%CI:0.710~0.917),AUC>0.8,有一定预测价值;半定量评分最佳阈值取13.535时,可以得到预测最佳的灵敏度及特异度,分别为83.3%和78.7%,约登指数为0.620。结论:肝脏彩超半定量分析能动态观察与评价慢性乙肝患者抗病毒治疗期间肝脏血流、门静脉内径等情况,评分的增加预示着患者抗病毒治疗期间终点事件高风险,对乙肝抗病毒治疗期间终点事件发生风险有一定预测价值。
Objective:To observe the value of semi-quantitative analysis of liver color ultrasound in predicting endpoint events during antiviral treatment of hepatitis B so as to guide the prediction of risk of poor prognosis during antiviral treatment of hepatitis B in future.Methods:80 patients with chronic hepatitis B who received antiviral treatment in hospital were selected,and they were divided into study group(30 cases whose end-point events included liver cirrhosis and liver cancer)and control group(50 cases who didn’t occurred end-point events)according to the occurrence of end-point events.All patients received color Doppler ultrasound on the liver.And the baseline data,routine results of liver color Doppler ultrasound and the scores of semi-quantitative analysis of two groups were compared.The correlation between the semi-quantitative scores and indexes of various liver color Doppler ultrasounds was analyzed,and the value of semi-quantitative scores in predicting endpoint events was evaluated.Results:The score of semi-quantitative ultrasound of study group was significantly higher than that of control group,and the liver size index of study group was significantly lower than that of control group,and the inner diameter of portal vein of study group was significantly larger than that of control group,and the blood flow velocity of portal vein of study group was significantly lower than that of control group,and the differences of them between the two groups were statistically significant(t=7.232,t=4.329,t=8.550,t=7.840,P<0.05).The score of ultrasound semi-quantitative of patients with chronic hepatitis B was negatively correlated with the liver size index and the blood flow velocity of portal vein(r=-0.403,r=-0.573,P<0.05),respectively,and it was positively correlated with the inner diameter of portal vein(r=0.362,P<0.05).And the receiver operating characteristic(ROC)curve was drawn,and then the area under curve(AUC)of ROC that could predict endpoint events by the score of semi-quantitative ultrasound was 0.814(95%CI:0.710~0.917),and the AUC was more than 0.8,which had a certain of predictive value.When the optimal threshold of semi-quantitative score was 13.535,the optimal sensitivity and specificity of prediction could be obtained,and they were 83.3%and 78.8%respectively,and the Youden index was 0.620.Conclusion:The semi-quantitative analysis of liver color Doppler ultrasound can dynamically observe and evaluate blood flow of liver and the inner diameter of portal vein,etc.of patients with chronic hepatitis B during antiviral treatment.And the increase of the score indicates the endpoint events have high risk during antiviral treatment,and it has certain of predictive value for the risk of endpoint events during antiviral treatment of hepatitis B.
作者
庹菲
孙克伟
王月爱
彭喜洋
TUO Fei;SUN Ke-wei;WANG Yue-ai(Department of Radiology,The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;不详)
出处
《中国医学装备》
2020年第10期103-107,共5页
China Medical Equipment
关键词
乙肝
抗病毒治疗
终点事件
肝脏彩超
半定量分析
Hepatitis B
Antiviral treatment
Endpoint event
Liver color Doppler ultrasound
Semi-quantitative analysis
