声触诊组织成像量化技术在临床诊断慢性乙型肝炎肝纤维化中的应用

Application of virtual touch quantification measurement in the clinical diagnosis of liver cirrhosis in chronic HBV-infected patients

目的探讨声触诊组织成像量化（VTQ）技术诊断慢性乙型肝炎（HBV）感染者肝纤维化的价值。方法应用VTQ技术对61例慢性HBV感染者（慢性乙肝组）和60例肝硬化患者（肝硬化组）进行检测,分析VTQ与肝功能、肾功能和凝血功能指标的相关性。结果对VTQ值与临床检验指标进行多重线性回归分析,回归模型中,VTQ值与胆碱酯酶（CHE）、血清白蛋白（ALB）呈负相关,与国际标准化比值（INR）呈正相关性,其中CHE对VTQ值影响最大。肝硬化组VTQ值显著高于慢性乙肝组（P〈0.01）。以VTQ≥1.22 m/s区分慢性乙肝及肝硬化患者,鉴别效能为0.726（95%CI：0.637~0.803,P=0.0001）,敏感度和特异度分别为83.05%和62.30%。结论 VTQ在诊断慢性HBV感染者肝纤维化严重程度方面有较好的应用价值。

Objective To observe the value of virtual touch quantification（VTQ） in the assessment of liver fibrosis in patients with chronic HBV-infection.Methods Liver stiffness measurement was performed with VTQ in 61 chronic HBV-infected patients（CHB group） and 60 patients of liver cirrhosis（LC group）.Correlation between VTQ values and the markers of liver function,renal function and blood coagulation were evaluated.Results Multiple linear regression showed negetive correlation between VTQ values and cholinesterase（CHE）,albumin（ALB）,and positive correlation between VTQ values and international normalized ration（INR）.CHE had most important impact on VTQ values.VTQ values of LC group were significantly higher than those of CHB group（P0.01）.Taking 1.22 m/s as the cut-of VTQ value,the area under ROC curve was 0.726（95%CI： 0.637—0.803,P=0.0001）,the sensitivity was 83.05%,and the specificity was 62.30% in discriminating LC from CHB.Conclusion VTQ is a valuable method for assessing the severity of liver fibrosis in the patients with chronic HBV.