原发性自身免疫性肝硬化的超声图征象及肝脏弹性的分析

Ultrasound Signs of Primary Autoimmune Cirrhosis and Analysis of Liver Elasticity

目的:探讨与分析原发性自身免疫性肝硬化的超声图征象及肝脏弹性特征。方法:研究时间为2017年2月至2019年12月,选择原发性自身免疫性肝硬化86例作为病例组,同期选择正常志愿者86例作为对照组,所有入选者都给予常规超声与弹性成像,记录成像特征并判断相关性。结果:病例组的全血谷草转氨酶(aspartate aminotransferase,AST)、谷丙转氨酶(alanine transarninase,ALT)、直接胆红素(direct bilirubin,DBIL)、总胆红素(total bilirubin,TBIL)与碱性磷酸酶(Alkaline phosphatase),ALP值都显著高于对照组(P<0.05)。病例组的肝脏回声、边界、内回声、血流等超声特征与对照组对比差异都有统计学意义(P<0.05)。病例组肝脏组织剪切波速度(shear wave velocity,SWV)、肝硬度高于对照组,应变率比值(Strain rate, SR)值低于对照组,对比差异都有统计学意义(P<0.05)。病例组的肝脏弹性硬度分级与对照组对比差异有统计学意义(P<0.05)。在病例组中,Pearson分析显示肝脏弹性硬度分级与肝脏回声、边界、内回声、血流等存在相关性(P<0.05)。结论:常规超声及肝脏弹性可反映原发性自身免疫性肝硬化的临床特征,两者存在相关性,可提高该病的鉴别诊断水平。

Objective: To explore and analysis the ultrasound signs and liver elasticity of primary autoimmune liver cirrhosis.Methods: The study period were from February 2017 to December 2019. 86 cases of primary autoimmune liver cirrhosis were selected as the case group, and 86 cases of normal volunteers were selected as the control group. All the cases were given conventional ultrasound and elastic Imaging, recording imaging features and judging correlation. Results: The whole blood AST, ALT, DBIL, TBIL and ALP values in the case group were significantly higher than those in the control group(P<0.05). The ultrasound characteristics of liver echo,border, internal echo, and blood flow in the case group were significantly different from those in the control group(P<0.05). The liver tissue shear wave velocity(SWV) and liver stiffness in the case group were higher than in the control group, and the SR value were lower than that in the control group that compared the differences were statistically significant(P<0.05). There were statistically significant difference in liver elasticity hardness compared between the case group and the control group(P<0.05). In the case group, Pearson analysis showed that there were correlation between liver elastic stiffness grade and liver echo, boundary, internal echo, blood flow(P<0.05). Conclusion: Routine ultrasound and liver elasticity can reflect the clinical characteristics of primary autoimmune liver cirrhosis.There are correlation between the two, which can improve the differential diagnosis of the disease.