自身免疫性肝炎患者的超声表现与病理及实验室检查的相关性分析

Correlation of the ultrasonic appearance and pathological/laboratory findings in autoimmune hepatitis

目的对照分析自身免疫性肝炎(AIH)患者的超声影像表现与临床生化指标及肝脏病理变化的相关性,研究通过超声影像诊断AIH的临床应用价值。方法选取2014年1月至2015年12月解放军第302医院收治的68例AIH患者的超声影像学表现、病理资料及临床实验室检查结果,研究超声影像表现与病理资料及实验室检查指标的相关性。结果超声诊断肝纤维化与病理上的"界面炎"表现与肝功的血清学指标对比,统计学上无相关性;但与病理上的"点状坏死"表现呈正相关(r=0.5099,P<0.001)。超声表现为"条索"与"结节"样改变对超声诊断AIH纤维化程度,差异有的统计学意义(t=3.9547,P<0.01)。超声检查显示肝脏的"大小"、"形态"改变与超声诊断AIH纤维化程度,差异有统计学意义(t=2.070、2.137、4.584、3.773,P均<0.05)。结论超声影像可为AIH的诊断及其纤维化程度的评估提供客观依据。

Objective The study was designed to comparatively analyze ultrasonic appearance, laboratory and pathological findings in autoimmune hepatitis （AIH）, and their correlation. The clinical value of ultrasound in diagnosing autoimmune hepatitis was studied. Methods By retrospectively reviewing the ultrasonic images, pathological and laboratory results of 68 patients with autoimmune hepatitis admitted to the PLA 302 Hospital from 2014 to 2015, we tried to reveal the correlation between ultrasonic features and pathological and laboratory findings. Results The ultrasonic diagnosis of liver fibrosis was not statistically correlated with the features of pathological ″interface hepatitis″ and serological liver function test. But it was positively correlated with the features of pathological ″spotty necrosis″ （r=0.5099, P〈0.001）. The ultrasonic features of ″cord-like structure″ and ″nodular change″ had statistically improved the classification of the degree of AIH fibrosis on ultrasonic diagnosis （t=3.9547, P〈0.01）. The ultrasonic feature of the change of ″liver size″ and ″morphology″ also have statistically improved the diagnosis of AIH fibrosis with ultrasonography （t=2.070, 2.137, 4.584, 3.773, all P〈0.05）. Conclusion Ultrasonic images could provide objective evidence in diagnosis of AIH and evaluation of fibrosis degree.