B超与血清学指标在肝纤维化诊断中的联合应用

Combined application of B-mode ultrasound test index and serum biomarkers to the diagnosis of hepatic fibrosis

目的联合B超检测指标与血清肝纤维化指标应用于肝纤维化诊断,探讨无创性肝纤维化诊断的临床价值。方法分别检测我院收治的85例慢性肝炎患者血清学指标[透明质酸(HA)、Ⅳ型胶原、层粘连蛋白(LN)及Ⅲ型前胶原(PCⅢ)]及B超指标(门静脉宽度、脾静脉宽度、肝左叶上下径、肝左叶前后径、肝右叶斜径),比较分析血清学指标、B超指标与肝纤维化的关系。结果慢性肝炎患者血清中各项肝纤维化指标HA、LN、Ⅳ型胶原及PCⅢ等含量随病情发展而逐渐升高(P<0.01)。重度慢性肝炎、肝硬化时,门静脉、脾静脉及肝左叶前后径明显增宽或增长(P<0.01),肝左叶上下径及肝右叶斜径则明显缩短(P<0.01)。结论血清学指标联合B超能更准确判断肝纤维化程度,有助于肝病的临床诊治,值得推广。

Objective To explore the clinical value of non-invasive hepatic fibrosis by combining the application of B-mode ultrasound test index and serum hepatic fibrosis index to the diagnosis of hepatic fibrosis. Methods Eighty-five cases of patients who suffered from chronic hepatitis admitted to our hospital were tested respectively in terms of serol-ogical index[hyaluronic acid（HA）,collagen Ⅳ（CⅣ）,laminin（LN）and procollagen（PCⅢ）]and B-mode ultrasound index [main portal vein（MPV）,splenic vein（SPV）],superoinferior diameter of left liver lobe,anteroposterior diameter of left liver lobe,oblique diameter of right liver lobe）. The relationship among serological index,B-mode ultrasound index and hepatic fibrosis was compared and analyzed. Results The assay of various hepatic fibrosis indexes HA,LN,CIV and PCⅢ etc. In the serum of patients suffering from chronic hepatitis was gradually increasing along with the progression of disease（P〈0.01）. At the time of severe chronic hepatitis and liver cirrhosis,portal vein,splenic vein and anteroposterior diameter of left live lobe were significantly broadened or increased（P〈0.01）,while superoinferior diameter of left liver lobe and oblique diameter of right live lobe were significantly shortened（P〈0.01）. Conclusion In combination with Bmode ultrasound,four indexes of hepatic fibrosis can more accurately judge the degree of hepatic fibrosis and are beneficial to clinical diagnosis and treatment of liver disease,which deserve promotion.