ARFI技术与红细胞参数评价肝豆状核变性患者肝组织纤维化程度的效能研究

Efficacy of ARFI technique and erythrocyte parameters in evaluating hepatic fibrosis in patients with hepatolenticular degeneration

目的研究声辐射力脉冲成像(ARFI)技术和红细胞参数评价肝豆状核变性(HLD)患者肝脏纤维化程度的效能。方法在我院确诊的168例肝豆状核变性患者和154例健康体检者,检测并比较两组血常规红细胞参数。在肝豆状核变性患者,在常规二维超声扫查的基础上,行肝脏ARFI技术检测剪切波速度(SWV),并与相应的红细胞参数进行相关性分析。结果肝豆状核变性患者红细胞数、血红蛋白浓度和红细胞体积分布宽度(RDW-CV)分别为(4.26±0.29)×10^(12)/L、(124.48±5.87)g/L和(13.20±3.76)%,均明显低于正常人水平[分别为(4.67±0.28)×1012/L、(138.43±7.95)g/L和[(11.87±3.20)%,P<0.01];红细胞平均容积为(85.71±2.49)fl,明显小于正常人的[(88.78±2.94)fl,P<0.01];肝豆状核变性患者肝脏剪切波速度为(2.05±0.58)m/s,与红细胞计数、血红蛋白浓度和平均红细胞体积分布宽度均呈负相关(r=-0.190,P=0.013;r=-0.197,P=0.011;r=-0.164,P=0.034),与RDW-CV呈正相关(r=0.177,P=0.021)。结论将超声ARFI技术和红细胞参数结合起来可以更好地评价肝豆状核变性患者肝脏的损害程度,对临床病情监测及预后评估具有重要意义。

Objective To study the efficacy of acoustic radiation imaging(ARFI) technique and erythrocyte parameters in assessing the degree of liver fibrosis in patients with hepatolenticular degeneration(HLD). Methods168 patients with HLD and 154 healthy subjects in our hospital were selected in this study. The peripheral blood erythrocyte parameters were measured and compared between the two groups. On the basis of conventional two-dimensional ultrasonography,the shear wave velocity(SWV) in HLD patients was measured by ARFI technique and the efficacy of them was obtained as for the liver fibrosis evaluation. R esults The red blood cell counts[(4.26±0.29)×1012/L vs.(4.67±0.28)×1012/L],hemoglobin concentration(HGB)[(124.48±5.87) g/L vs.(138.43±7.95) g/L] and red blood cell volume distribution width [(RDW-CV,(13.20 ±3.76)% vs.(11.87 ±3.20) %] in patients with HLD were significantly lower than those in the normal controls(P <0.01);the mean red blood cell volume(MCV) in patients with HLD was much smaller than [(85.71±2.49) fl vs.(88.78±2.94)fl,P<0.01] in the healthy persons;the shear wave velocity in HLD patients were(2.05 ±0.58) m/s,which was negatively correlated with RBC(r=-0.190,P=0.013),HGB(r=-0.197,P=0.011) and MCV(r=-0.164,P =0.034) in HLD patients,and positively correlated with RDW-CV(r=0.177,P=0.021). Conclusion Ultrasound ARFI technique combined with erythrocyte parameters can properly evaluate the degree of liver damage in patients with HLD,which is important for clinical disease monitoring and prognosis evaluation.