超声弹性成像参数诊断慢性乙型肝炎肝纤维化临床分析

Value of ultrasound elastography parameters in diagnostic efficacy and efficacy evaluation in chronic hepatitis B fibrosis

目的探讨超声弹性成像(RTE)参数在慢性乙肝肝纤维化中诊断价值。方法选取我院慢性乙肝肝纤维化患者79例设为观察组,另选取同期健康体检者79例设为对照组。两组均实施RTE检查,并给予观察组对应治疗措施。对比观察组及对照组、观察组不同疾病分期患者RTE参数〔峰度(KURT)、偏度(SKEW)、复杂度(COMP)、对比度(CONT)、标准差(SD)、应变均值(MEAN)〕,采用Pearson分析RTE参数与疾病分期关联性,采用接收者操作特征(ROC)曲线及ROC下面积(AUC)分析RTE诊断价值。结果观察组KURT、MEAN小于对照组,SKEW、COMP、CONT、SD大于对照组(P<0.05);随疾病分期增高,KURT、MEAN呈降低趋势,SKEW、COMP、CONT、SD呈增高趋势(P<0.05);KURT、MEAN与慢性乙肝肝纤维化疾病分期呈负相关,SKEW、COMP、CONT、SD与疾病分期间呈正相关(P<0.05);诊断慢性乙肝肝纤维化的AUC:KURT为0.774,SKEW为0.680,COMP为0.809,CONT为0.735,SD为0.781,MEAN为0.820(P<0.05);治疗后KURT、MEAN较治疗前增高,SKEW、COMP、CONT、SD较治疗前降低(P<0.05)。结论RTE参数可鉴别诊断慢性乙肝肝纤维化,与疾病分期显著相关,并能无创、重复性监测抗肝纤维化治疗的疗效。

Objective To investigate the value of ultrasound elastography(RTE)parameters in the diagnosis and efficacy evaluation of chronic hepatitis B fibrosis.Methods From November 2017 to November 2019,79 patients with chronic hepatitis B liver fibrosis in our hospital were selected as the study group,and 79 patients with healthy physical examination during the same period were selected as the control group.RTE was performed in both groups,and corresponding treatment measures were given to the study group.Compared the RTE parameters〔kurtosis(KURT),skewness(SKEW),complexity(COMP),contrast(CONT),standard deviation(SD),strain mean(MEAN)〕of patients in the study group and control group,and patients in the control group with different disease stages,Pearson was used to analyze the correlation between RTE parameters and disease stage,and the receiver operating characteristic(ROC)curve and area under the ROC(AUC)were used to analyze the value of RTE in the diagnosis of chronic hepatitis B fibrosis.Results KURT and MEAN in the study group were smaller than those in the control group,and SKEW,COMP,CONT,and SD were larger than those in the control group(P<0.05);with the increase of disease stage,KURT and MEAN showed a decreasing trend,and SKEW,COMP,CONT,and SD showed an increasing trend(P<0.05);KURT and MEAN were negatively correlated with the stage of chronic hepatitis B fibrosis disease,while SKEW,COMP,CONT,and SD were positively correlated with the stage of disease(P<0.05);AUC for the diagnosis of chronic hepatitis B fibrosis:KURT was 0.774,SKEW was 0.680,COMP was 0.809,CONT was 0.735,SD was 0.781,and MEAN was 0.820(P<0.05);after treatment,KURT and MEAN were higher than before treatment,and SKEW,COMP,CONT,and SD were lower than before treatment(P<0.05).Conclusion The RTE parameter can be used for the differential diagnosis of chronic hepatitis B fibrosis,which is significantly related to the stage of the disease,and can non-invasively and repeatedly monitor the efficacy of anti-liver fibrosis therapy.