慢性肝病肝剪切波速与血清肝纤维化标志物在肝纤维化诊断中的对比研究

Comparative study between liver shear wave velocity and serum liver fibrosis markers in diagnosis of liver fibrosis in chronic hepatic diseases

目的探讨慢性肝病肝剪切波速及血清肝纤维化标志物在肝纤维化分级诊断中的临床应用价值。方法选择235例慢性肝病患者（肝纤维化组）,其中男性179例,女性56例;年龄17-64岁,平均年龄36.3岁。40例健康对照者,其中男性25例,女性15例;年龄25-62岁,平均年龄43.2岁。先进行肝剪切波速和抽血实验室检查,然后在超声引导下穿刺活组织检查,以病理结果为标准,分析剪切波速及血清肝纤维化标志物在评价肝纤维化分级之间的关系。并将检查结果与健康对照者进行比较。结果235例慢性肝病患者有215例进行肝穿刺活组织检查,除F0级肝病患者与健康对照组F0级之间剪切波速比较差异无统计学意义（P〉0.05）外,其余肝病各分组剪切波速随肝纤维化程度的增高而波速增快;且血清肝纤维化标志物含量亦随肝纤维化病理分期的增高而增高。结论肝剪切波速及血清肝纤维化标志物对肝纤维化患者的病理分期有良好相关性,对肝纤维化的诊断及疗效观察有重要的临床应用价值。

Objective To explore clinical value of liver shear wave velocity and serum fibrosis markers in chronic hepatic diseases for the grading diaguosis of liver fibrosis. Methods A total of 235 patients with chronic hepatitis were enrolled, male 179, female 56, aged 17 - 64 years old, mean age 36.3 years old. Forty healthy people were as the control, male 25, female 15, aged 25 - 62 years old, mean age 43.2 years old. All of them performed liver shear wave velocity and blood laboratory tests, and then carried out liver biopsy under ultrasound-guided. The pathologic finding was as the standard. The relationship between shear wave velocity and serum liver fibrosis markers for liver fibrosis grading was analyzed, and the test results were compared with the healthy controls. Results The 215 of 235 patients were underwent percutaneous liver biopsy. The liver shear wave velocity showed no significant difference between F0 and healthy control group. In other groups, both shear wave velocity and the content of serum liver fibrosis markers increased with the degree of liver fibrosis. Conclusion It is demonstrated that both shear wave velocity and serum liver fibrosis markers are very correlated with pathologic stage of liver fibrosis, and which has important clinical value for the diaznosis and curative effects of hepatic fibrosis.