胆囊壁厚度结合ARFI、门静脉宽度及生化指标评估肝炎后肝纤维化

Gallbladder wall thickness combined with acoustic radiation force impulse imaging, portal vein width and biochemical parameters for assessing liver fibrosis caused by hepatitis

目的:本研究旨在探讨肝炎后肝纤维化胆囊壁的厚度与肝纤维化的进展及其严重程度的关系,为临床诊治提供参考.方法:回顾性分析2014-03/2015-03兰州大学第一医院收住的确诊为不同阶段肝纤维化并行声辐射力脉冲成像检查的76例患者.所有纳入病例均有明确肝病病史、典型临床表现及实验室检查.排除既往有胆囊疾病的患者.收集胆囊壁厚度、肝脏弹性指数、门静脉宽度及有无腹水、血清白蛋白、血胆红素、凝血酶原时间等相关检查数据,用SPSS19.0统计软件进行数据分析及处理.结果:肝纤维化分级与胆囊壁厚度、肝脏弹性指数、门脉宽度、血清白蛋白及腹水量呈正相关(P<0.05),差异具有统计学意义;而胆囊壁厚度与弹性指数、门脉宽度及腹水量亦呈正相关(P<0.05),与血清白蛋白呈负相关(P<0.05),差异均具有统计学意义.结论:胆囊壁的厚度结合弹性指数、门脉宽度、血清白蛋白及腹水量可以评估纤维化的进展及其严重程度.胆囊壁厚度亦可作为独立指标评估肝纤维化.

AIM： To investigate the relationship between the thickness of the gallbladder wall and the progress and severity of hepatic fibrosis, in order to provide a reference for clinical diagnosis and treatment of hepatic fibrosis.METHODS： A retrospective analysis was performed of 76 patients with different stages of liver fibrosis who underwent acoustic radiation force impulse imaging from March 2014 to March 2015 at the First Hospital of Lanzhou University. All patients had a history of liver disease, typical clinical manifestations and laboratory tests. The patients with a history of gallbladder disease were excluded. The thickness of the gallbladder wall, liver elasticity index, width of portal vein, the presence of ascites, serum albumin, serum bilirubin, and prothrombin time were statistically analyzed.RESULTS： Grade of hepatic fibrosis was significantly positively correlated with gllbladder wall thickness, liver elasticity index, portal vein width, serum albumin and ascites volume（P〈0.05）. Gallbladder wall thickness was significantly positively associated with elasticity index, portal width and ascites volume（P〈0.05）, but negatively associated with serum albumin（P〈0.05）.CONCLUSION： Combined use of thickness of the gallbladder wall, elasticity index, portal width, serum albumin and ascites can improve the assessment of the progress and severityof fibrosis. Gallbladder wall thickness may be used as independent indicator to assess liver fibrosis.