彩色多普勒超声半定量评分法在早期病毒性肝炎肝硬化诊断中的应用效果分析

An analysis of the application effect of semi-quantitative score method of color Doppler ultrasound on the early diagnosis of viral hepatitis cirrhosis

目的:分析研究彩色多普勒超声半定量评分法在早期病毒性肝炎肝硬化诊断中的应用效果。方法:选取在医院治疗的经肝穿刺活检证实为慢性乙型病毒性肝炎的118例患者,将其依据穿刺活检结果分为非硬化组(63例)及早期硬化组(55例)。对所有入组患者均进行彩色多普勒超声检查,并同时进行半定量评分,比较两组间的差异。结果:早期硬化组患者肝脏表面的被膜情况、肝脏整体形态、肝实质回声情况、肝内静脉显示情况、肝内韧带显示情况、胆囊壁形态及脾脏体积的半定量评分明显高于非硬化组,两组比较差异有统计学意义(t=7.543,t=6.892,t=6.135,t=7.233,t=5.754,t=6.652,t=6.781;P<0.05);彩色多普勒超声半定量评分对于诊断早期肝硬化的灵敏度为98.18%(54/55),特异度为96.83%(61/63);阳性预测值为96.43%(54/56),阴性预测值为98.38%(61/62)。结论:彩色多普勒超声半定量评分法对于慢性乙型病毒性肝炎肝硬化的各项肝脏指标有着十分紧密的联系,对于早期肝硬化的诊断效果明显,值得临床推广应用。

Objective： To analyze the application effect of semi-quantitative score method of color Doppler ultrasound on the diagnosis of viral hepatitis cirrhosis of early stage. Methods： 118 patients with chronic viral hepatitis B who were confirmed by using liver biopsy. According to the results, these patients were divided into non-sclerosis group（63 cases） and sclerosis group（55 cases）. And color Doppler ultrasound was implemented on all enrolled patients, at the same time, a semi-quantitative score was implemented. And then the difference of these results between the two groups was compared. Results： The semi-quantitative scores of surface envelope of liver, entirety morphology of liver, echo of liver parenchyma, display of intrahepatic vein, display of intrahepatic ligament, morphology of gall bladder wall and volume of spleen of sclerosis group were significantly higher than those of non-sclerosis group（t=7.543, t=6.892, t=6.135, t=7.233, t=5.754, t=6.652, t=6.781, P〈0.05）. The sensitivity, specificity, positive predictive value and negative predictive value of semi-quantitative scores of color Doppler ultrasound in diagnosing cirrhosis of early stage were 98.18%（54/55）, 96.83%（61/63）, 96.43%（54/56） and 98.38%（61/62）. Conclusion： Semi-quantitative score method of color Doppler ultrasound has very closely connection with each indicator of liver cirrhosis of chronic hepatitis B, and its diagnostic effect on the cirrhosis of early stage is significant. Therefore, it is worthy to be popularized in clinical practice.