肝硬化患者肝脏瞬时弹性成像与肝功能Child-Pugh分级的相关性研究

The correlation between transient elastrography and liver function Child-Pugh grade in patients with liver cirrhosis

目的探讨肝硬化患者肝脏瞬时弹性成像（TE）与肝功能Child-Pugh分级之间的相关性。方法回顾性分析120例肝硬化患者的临床资料，其中乙型肝炎性肝硬化103例，合并腹水57例。患者均采用瞬时弹性扫描仪检测肝脏硬度值（LSM），采用肝功能Child-Pugh系统评分法判定患者肝功能Child-Pugh分级，比较不同肝功能Child-Pugh分级患者的LSM。结果120例肝硬化患者中，Child-Pugh A级39例，Child-Pugh B级28例，Child-Pugh C级53例，Child-Pugh B级和C级患者LSM明显高于Child-Pugh A级患者[（20.2 ± 1.1）和（30.8 ± 1.2）kPa比（15.7 ± 1.4）kPa]，Child-Pugh C级患者明显高于Child-Pugh B级患者，差异有统计学意义（P〈0.05）。103例乙型肝炎性肝硬化患者中，Child-Pugh A级33例，Child-Pugh B级24例，Child-Pugh C级46例，Child-Pugh B级和C级患者LSM明显高于Child-Pugh A级患者[（18.7 ± 0.9）和（26.9 ± 0.6）kPa比（12.6 ± 1.7）kPa]，Child-Pugh C级患者明显高于Child-Pugh B级患者，差异有统计学意义（P〈0.05）。57例合并腹水的肝硬化患者中，Child-Pugh B级11例，Child-Pugh C级46例，Child-Pugh C级患者LSM明显高于Child-Pugh B级患者[（42.3 ± 1.4）kPa比（35.1 ± 1.0）kPa]，差异有统计学意义（P〈0.05）。103例乙型肝炎性肝硬化患者中合并腹水49例，其中Child-Pugh B级10例，Child-Pugh C级39例，Child-Pugh C级患者LSM明显高于Child-Pugh B级患者[（40.6 ± 0.9）kPa比（33.2 ± 1.5）kPa]，差异有统计学意义（P〈0.05）。结论肝硬化患者肝功能Child-Pugh分级越高，LSM越大，两者具有相关性；在乙型肝炎性肝硬化患者中的结果相似。TE可用来评估肝硬化的严重程度，具有一定临床价值。

ObjectiveTo evaluate the correlation between transient elastrography （TE） and liver function Child-Pugh grade in patients with liver cirrhosis.MethodsThe clinical data of 120 patients with liver cirrhosis were retrospectively analyzed. Among the patients, hepatitis-B virus-related cirrhosis was in 103 cases, and 57 patients had ascites. The liver stiffness measurement （LSM） was measured by FibroScan. The liver function Child-Pugh grade was evaluated by liver function Child-Pugh system score. The LSM was compared in patients with different liver function Child-Pugh grade.ResultsAmong the 120 patients with liver cirrhosis, Child-Pugh A grade was in 39 cases, Child-Pugh B grade in 28 cases, and Child-Pugh C grade in 53 cases. The LSM in Child-Pugh B grade patients and C grade patients were significantly higher than that in Child-Pugh A grade patients： （20.2 ± 1.1） and （30.8 ± 1.2） kPa vs. （15.7 ± 1.4） kPa, the LSM in Child-Pugh C grade patients was significantly higher than that in Child-Pugh B grade patients, and there were statistical differences （P〈0.05）. Among the 103 patients with hepatitis-B virus-related cirrhosis, Child-Pugh A grade was in 33 cases, Child-Pugh B grade in 24 cases, and Child- Pugh C grade in 46 cases. The LSM in Child-Pugh B grade patients and C grade patients were significantly higher than that in Child-Pugh A grade patients： （18.7 ± 0.9） and （26.9 ± 0.6） kPa vs. （12.6 ± 1.7） kPa, the LSM in Child-Pugh C grade patients was significantly higher than that in Child-Pugh B grade patients, and there were statistical difference （P〈0.05）. Among the 57 patients associated ascites, Child-Pugh B grade was in 11 cases, and Child-Pugh C grade in 46 cases. The LSM in Child-Pugh C grade patients was significantly higher than that in Child-Pugh B grade patients： （42.3 ± 1.4） kPa vs. （35.1 ± 1.0） kPa, and there was statistical difference （P〈0.05）. Among the 103 patients with hepatitis-B virus-related cirrhosis, associated ascites was in 49 cases, Child-Pugh B grade was in 10 cases, and Child-Pugh C grade in 39 cases. The LSM in Child-Pugh C grade patients was significantly higher than that in Child-Pugh B grade patients： （40.6 ± 0.9） kPa vs. （33.2 ± 1.5） kPa, and there was statistical difference （P〈0.05）.ConclusionsThe LSM values of patients with liver cirrhosis are higher with the elevation of liver function Child-Pugh grade. There is a correlation between LSM values and Child-Pugh scores. The LSM can partly evaluate the severity of liver disease in patients with liver fibrosis.