摘要
目的评估超声弹性成像(UE)检测肝脏、脾脏硬度值及血清肝纤维化指标(APRI、FIB-4、和King′s评分)对慢性乙型肝炎(CHB)患者肝纤维化程度的表现。方法选取2018年10月至—2021年08月周口市中心医院收治的98例CHB患者为研究对象,男性51例,女性47例,年龄(35.3±7.8)岁。应用UE检测每例招募患者的肝脏硬度值(LSM)和脾脏硬度值(SSM),同时完成UE检查后均接受超声引导下肝活检。结果UE测量成功率为100%,数据可靠。男性AST、LSM和SSM为(86.0±23.1)U/L、(10.6±3.4)kPa和(18.1±4.7)kPa,均显著高于女性[(71.4±19.3)U/L、(8.7±2.7)kPa和(15.5±5.4)kPa,P<0.05];男性年龄和GGT为(34.7±6.4)岁、(70.6±29.3)U/L,与女性[(37.0±6.8)岁、(88.2±34.5)U/L],差异具有统计学意义(P<0.05)。随着肝纤维化程度的增加,LSM、SSM、APRI、FIB-4及King′s评分均显著性增加(P<0.05)。在评估≥S2期肝纤维化时,LSM、SSM诊断AUC值均分别显著高于APRI、FIB-4及King′s评分(P<0.05)。LSM诊断≥S2期肝纤维化时,AUC、截断点、敏感度及特异度分别为0.82、7.8 kPa、77.4%及92.5%;SSM诊断≥S2期肝纤维化时AUC、截断点、敏感度及特异度分别为0.85、8.7 kPa、80.6%及94.0%。结论相较于APRI、FIB-4、和King’s评分,通过UE检测LSM、SSM对CHB肝纤维化分期的诊断效能最为理想。
Objective To assess liver fibrosis in patients with chronic hepatitis B(CHB)by liver and spleen stiffness measurement based on ultrasonic elastography(UE),and serum liver fibrosis indexes(APRI,FIB-4,and King′s score).Methods A total of 98 CHB patients were selected as the research subjects from October 2018 to August 2021.The participants included 51 males and 47 females,with an age of(35.3±7.8)years.UE was used to measure liver hardness(LSM)and spleen hardness(SSM)in each patient.Additionally,all patients underwent ultrasound-guided liver biopsy after the UE examination.Results The success rate of UE measurement was 100%,and the data was reliable.The AST,LSM and SSM of male were(86.0±23.1)U/L,(10.6±3.4)kPa and(18.1±4.7)kPa,which were significantly higher than those of female[(71.4±19.3)U/L,(8.7±2.7)kPa and(15.5±5.4)kPa,P<0.05].The age and GGT of males were(34.7±6.4)years and(70.6±29.3)U/L,respectively,which were significantly different from those of females((37.0±6.8)years and(88.2±34.5)U/L)(P<0.05).With the increase of liver fibrosis,LSM,SSM,APRI,FIB-4 and King′s scores increased significantly(P<0.05).The AUC values of LSM and SSM were significantly higher compared to APRI,FIB-4 and King′s scores(P<0.05)when evaluating≥S2 hepatic fibrosis.The AUC,cut-off point,sensitivity and specificity of LSM in diagnosing≥S2 hepatic fibrosis were 0.82,7.8 kPa,77.4%and 92.5%,respectively.The AUC,cut-off point,sensitivity and specificity of SSM in diagnosis of≥S2 hepatic fibrosis were 0.85,8.7 kPa,80.6%and 94.0%,respectively.Conclusion Compared to APRI,FIB-4,and King′s scores,LSM and SSM detected by UE exhibit superior diagnostic efficiency for CHB liver fibrosis staging.
作者
殷琳琳
吕慧
王戊辰
刘学进
YIN Lin-lin;LV Hui;WANG Wu-chen;LIU Xue-jin(Department of Gastroenterology department 2,Zhoukou Central Hospital,Zhoukou,Henan,466000,China)
出处
《肝脏》
2023年第9期1064-1067,共4页
Chinese Hepatology
基金
河南省医学科技攻关计划联合共建项目(LHGJ20190519)。
关键词
超声弹性成像
肝纤维化
慢性乙型肝炎
Ultrasonic elastography
Liver fibrosis
Chronic hepatitis B
