慢性乙型肝炎声辐射力脉冲检测肝脏弹性的影响因素分析

Analysis of Influencing Factors of Acoustic Radiation Force Pulse in Detecting Liver Elasticity in Patients with Chronic Hepatitis B

【目的】探讨声辐射力脉冲技术(acoustic radiation force impulse,ARFI)检测慢性乙型肝炎(CHB)患者肝脏弹性的影响因素。【方法】回顾性分析本院2014年8月至2018年8月收治的80例CHB患者的临床资料,所有患者均于入院当日接受ARFI检查,测定肝脏弹性。根据患者是否检测成功分为成功组、失败组。比较两组受检者的临床特征,包括性别、年龄、体质量指数(BMI)、炎症程度(G)、肝纤维化分级(S)、脂肪变分级(F)、检测体位,分析检测质量与临床特征的关系。利用Logistic回归模型分析ARFI检测CHB患者肝脏弹性的影响因素。【结果】在80例患者中,有64(80.00%)例检测成功,16(20.00%)例检测失败。成功组BMI<24 kg/m^(2)、脂肪变分级为F1级、平卧位检测占比分别为65.63%、95.31%、53.13%、59.38%,高于失败组的37.50%、31.25%、0.00%、25.00%(P<0.05)。Logistic回归模型提示BMI(≥24 kg/m^(2))、脂肪变分级(F2~F3级)、检测体位(侧卧位)是ARFI检测CHB患者肝脏弹性的影响因素(P<0.05)。【结论】ARFI检测CHB患者肝脏弹性会受BMI、脂肪变分级与检测体位的影响,检测人员需对此引起重视。

【Objective】To investigate the influencing factors of acoustic radiation force impulse(ARFI)in detecting liver elasticity in patients with chronic hepatitis B(CHB).【Methods】The clinical data of 80 patients with CHB admitted to our hospital from August 2014 to August 2018 were retrospectively analyzed.All patients received ARFI examination on the day of admission to determine the liver elasticity.Patients were divided into success group and failure group according to whether the detection was successful.The clinical characteristics of the two groups were compared,including gender,age,body mass index(BMI),degree of inflammation(G),liver fibrosis grade(S),steatosis grade(F),and detection position.The relationship between detection quality and clinical characteristics was analyzed.Logistic regression model was used to analyze the influencing factors of liver elasticity in patients with CHB detected by ARFI.【Results】Of the 80 patients,64(80.00%)were successful and 16(20.00%)failed.BMI<24 kg/m^(2),steatosis grade F1 and supine position detection accounted for 65.63%,95.31%,53.13%and 59.38%respectively in the success group,which were higher than 37.50%,31.25%,0.00%and 25.00%in the failure group(P<0.05).Logistic regression model suggested that BMI(≥24 kg/m^(2)),steatosis grade(F2-F3)and body position(lateral position)were the influencing factors of liver elasticity in patients with CHB detected by ARFI(P<0.05).【Conclusion】The detection of liver elasticity in patients with CHB by ARFI is affected by BMI,steatosis grade and body position,which should be paid attention to.