肝脏瞬时弹性成像对慢性乙型肝炎肝纤维化的应用价值

The Application Value of Transient Elastography in Liver Fibrosis of Chronic Hepatitis B

目的:探讨肝脏瞬时弹性成像对慢性乙型肝炎肝纤维化的应用价值。方法:选择2017年2月~2018年2月本院慢性乙型肝炎感染患者70例为观察对象,分别采用瞬时弹性波扫描仪对患者肝脏瞬时弹性成像,对患者血清谷丙转氨酶(ALT)、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)进行检测。行彩超引导下肝穿刺,制作常规切片,依据病毒学干预防治方案对患者的肝纤维化进行分期。观察不同肝纤维化分期患者的LSM、ALT和HBVDNA的相关性,探讨肝脏瞬时弹性成像对慢性乙型肝炎肝纤维化的应用价值。结果:本组70例患者中,未见S0和S4期患者。S1期患者35例,占比50.0%;S1期患者20例,占比28.6%;S1期患者15例,占比21.4%。患者的肝硬度值随着肝纤维化病理分期加重而增大,ALT呈上升趋势,HBV-DNA下降,各分期患者间的ALT、HBV-DNA、LSM比较,差异有统计学意义(P<0.05)。结论:肝脏瞬时弹性成像是一种无创的检查方法,其操作简单,可重复性好,对慢性乙型肝炎肝纤维化、肝硬化具有很好的诊断价值。

Objective:To explore the application value of transient elastography of liver on liver fibrosis in chronic hepatitis B patients.Methods:A total of 70 patients with chronic hepatitis B infection in our hospital from February 2017 to February 2018 were selected,and transient elastography was performed on the patient’s liver with transient elastography,and the serum alanine aminotransferase(ALT)and hepatitis B virus Detection of DNA(HBV-DNA).Hepatic puncture guided by color Doppler ultrasound,routine sections were made,and liver fibrosis of patients was staged according to virological interventions.To observe the correlation between LSM,ALT and HBV-DNA in patients with different stages of liver fibrosis,and to explore the application value of transient elastography of liver on liver fibrosis in chronic hepatitis B patients.Results:Of the 70 patients in this group,no patients in S0 and S4 stages were seen.There were 35 patients with S1 stage,accounting for 50.0%;20 patients with S1 stage,accounting for 28.6%;15 patients with S1 stage,accounting for 21.4%.The liver stiffness of patients increased with the pathological stages of liver fibrosis,ALT showed an upward trend,and HBV-DNA decreased.There was a statistically significant difference in ALT,HBV-DNA,and LSM among patients in each stage(P<0.05).Conclusion:Transient elastography of the liver is a non-invasive examination method with simple operation and good reproducibility.It has good diagnostic value for chronic hepatitis B fibrosis and cirrhosis.