慢性HBV感染者各级肝脏纤维化不同部位VTQ测值比较研究

The difference of virtual touch quantification(VTQ) among different parts in the hepatic fibrosis of chronic HBV

目的:进行慢性乙肝病毒(HBV)感染者各级肝脏纤维化不同部位声触诊量化技术(VTQ)测值的比较研究。方法:测定311例慢性肝病患者肝左叶、肝右前叶、肝右后叶VTQ值,慢性肝病患者均经肝穿刺活检,并行病理肝纤维化分级,以病理肝纤维化分级进行分组,分别对各组不同部位VTQ值进行对比研究。结果:311例中无S0级(因我院所有肝穿刺患者,肝功均有异常且病史较长,所以S0级极少见);S1级中,肝左叶与肝右前叶、肝右后叶差异有统计学意义(P<0.01),肝右前叶与肝右后叶差异无统计学意义(P=0.333);S2级中,肝左叶与肝右前叶、肝右后叶差异有统计学意义(P<0.01),肝右前叶与肝右后叶差异无统计学意义(P=0.505);S3级中,肝左叶、肝右前叶、肝右后叶两两间差异均无统计学意义(P>0.05);S4级中,肝左叶、肝右前叶、肝右后叶两两间差异均无统计学意义(P>0.05)。结论:测量肝左叶VTQ值时,因受心脏搏动、呼吸、腹主动脉搏动影响,测量值可信度差。因此,不宜用此部位VTQ测值估测肝纤维化程度。

Objective： To explore the difference of virtual touch quantification （VTQ） among dlflerent parts in the iaepatlc tlbro-sis of chronic HBV. Methods： A total of 311 patients with chronic liver disease receiving liver biopsy were enrolled in this stud- y, all patients liver tissue in the left lobe, the anterior and posterior of right lobe was checked by VTQ technique. The results were compared in different parts and the patients were grouped according to the degree of the hepatic fibrosis. Results： None of SO was included in 311 patients, for they had abnormal liver function and a long course. In S1 group, VTQ value was signifi-cantly different among the left lobe, the anterior and posterior of right lobe （P〈0.01）. No significant difference showed be-tween the anterior and posterior of right lobe（P=0. 333）. In $2 group, VTQ value was significantly different among the left lobe, the anterior and posterior of right lobe （P〈0.01）. No significant difference showed between the anterior and posterior of right lobe （P=0. 505）. In S3 group, no significant difference showed among the left lobe, the anterior and posterior of right lobe（P〉0.05）. In S4 group, no significant difference showed among the left lobe, the anterior and posterior of right lobe（P〉 0.05）. Conclusion：The credibility of the VTQ value in left lobe is poor, for heart beat, breathing, abdominal aorta pulse could produce an effect on the act of measuring. In a word, it is not scientific to measure VTQ value in the left lobe of the liver.