摘要
目的探究超声检测肝区域速度指数(zone speed index,ZSI)和肝脏实质回声在乙肝肝纤维化诊断中的价值。方法选取2017年4月至2018年4月无锡市第五人民医院乙肝肝纤维化患者90例作为研究组,同期健康体检者50名作为对照组。通过病理学检测对所研究的肝纤维化进行分期,研究组和对照组均接受超声检测,评估或计算肝脏实质回声评分和ZSI。比较不同肝纤维化分期患者的肝脏实质回声评分和ZSI,并采用受试者工作特征(ROC)曲线分别评价肝脏实质回声评分和ZSI数值对肝纤维化的诊断价值。结果研究组S1、S2、S3和S4的患者数分别为36例、22例、12例和20例。方差分析结果显示,不同肝纤维化分期患者的肝脏实质回声评分和ZSI比较,差异有统计学意义( P <0.05)。LSD多重比较分析结果显示,肝脏实质回声评分和ZSI的S1与S2、S3与S4比较,差异无统计学意义( P >0.05),其余差异有统计学意义( P <0.05)。肝脏实质回声评分和ZSI与肝纤维化分期呈正相关( P <0.05)。ROC分析结果显示,ZSI对不同肝纤维化分期的ROC曲线下面积均大于肝脏实质回声,且ZSI对肝纤维化分期为S3时具有最大的ROC曲线下面积,为0.915,临界值为28.36 m/s。结论超声ZSI指标对于乙肝肝纤维化具有更好的诊断价值。
Objective To investigate the value of ultrasound detection of liver zone speed index (ZSI) and liver parenchymal echo in the diagnosis of hepatitis B liver fibrosis. Methods Ninety patients with liver fibrosis were selected as study group in Wuxi No.5 People’s Hospital from Apr. 2017 to Apr. 2018, and 50 healthy subjects were used as control group. The liver fibrosis of the study was staged by pathological examination. Both study group and control group were subjected by ultrasound examination to evaluate or calculate the liver parenchymal echo score and the liver ZSI. The liver parenchymal echo score and ZSI of patients with different stages of liver fibrosis were compared, and the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of liver parenchyma echo score and ZSI value for liver fibrosis. Results The number of patients in study group of S1, S2, S3, and S4 were 36, 22, 12, and 20 cases, respectively. The results of analysis of variance showed that the hepatic parenchymal echo scores and ZSI of different liver fibrosis stages were significantly different ( P <0.05). The results of multiple comparison analysis of LSD showed that there was no significant difference between S1 and S2, between S3 and S4 of liver parenchymal echo score and ZSI ( P >0.05), and the others were significantly different ( P <0.05). Hepatic parenchymal echo score and ZSI were positively related with liver fibrosis stage ( P <0.05). The results of ROC analysis showed that the area under the ROC curve of ZSI for different liver fibrosis stages was greater than that of liver parenchymal echo, and ZSI had the largest area under the ROC curve for liver fibrosis stage with S3, which was 0.915 and the critical value was 28.36 m/s . Conclusion Ultrasound ZSI has a better diagnostic value for hepatitis B liver fibrosis.
作者
井艳飞
杜合娟
JING Yanfei;DU Hejuan(Department of Ultrasound,Wuxi No.5 People’s Hospital, Wuxi 214000, China;Department of Hepatology, Wuxi No.5 People’s Hospital, Wuxi 214000, China)
出处
《胃肠病学和肝病学杂志》
CAS
2019年第8期919-922,共4页
Chinese Journal of Gastroenterology and Hepatology
基金
南京医科大学科技发展基金(2013NJMU195)
关键词
慢性乙型肝炎
肝纤维化
超声检测
Chronic hepatitis B
Liver fibrosis
Ultrasound detection