摘要
目的研究血清学指标、瞬时弹性成像技术对慢性乙型病毒性肝炎(HBV)患者肝纤维化程度的临床诊断价值。方法收集该院2019年10月—2020年10月收治的慢性HBV患者的临床资料(无肝纤维化者7例,轻度肝纤维化者49例,中重度肝纤维化者48例)。比较不同肝纤维化程度慢性HBV患者肝硬度测量(LSM)值、乙型肝炎病毒E抗原(HBeAg)、天冬氨酸转氨酶(AST)/丙氨酸转氨酶(ALT)、APRI及上述指标与慢性HBV患者肝纤维化程度的相关性,并分析上述指标联合检测对慢性HBV患者肝纤维化的诊断价值。结果无肝纤维化组LSM、AST/ALT及APRI值显著低于轻度、中重度肝纤维化组,以中重度肝纤维化组最高;HBeAg水平显著高于轻度、中重度肝纤维化组,以中重度肝纤维化组最低(均P<0.05)。相关性分析结果显示,慢性HBV患者肝纤维化程度与LSM、AST/ALT及APRI均呈正相关,与HBeAg呈负相关(均P<0.05)。采用ROC曲线分析瞬时弹性成像、HBeAg、AST/ALT及APRI单项及联合检测对慢性HBV患者肝纤维化的诊断价值,以四者联合检测曲线下面积最大,为0.909。结论血清学指标、瞬时弹性成像技术对慢性HBV患者肝纤维化程度均具有一定诊断价值,两者联合检测可有效提高诊断准确性。
Objective To study the clinical diagnostic value of serological indicators and transient elastography for the degree of liver fibrosis in patients with chronic hepatitis B virus(HBV).Methods The clinical data of chronic HBV patients admitted in Wenjiang Branch of Sichuan Provincial People′s Hospital from October 2019 to October 2020(including seven cases without liver fibrosis, 49 cases with mild liver fibrosis, 48 cases with moderate to severe liver fibrosis) were collected.The liver stiffness measurement(LSM) values, Hepatitis B virus e antigen(HBeAg),Aspartate transaminase(AST)/Alanine aminotransferase(ALT),aspartate aminotransferase-to-platelet ratio index(APRI) and the correlation between the above indicators and the degree of liver fibrosis in chronic HBV patients were compared.The diagnostic value of combined detection of the above indicators in chronic HBV patients with liver fibrosis was analyzed.Results The LSM,AST/ALT and APRI values of the non-liver fibrosis group were significantly higher than those of the mild, moderate-severe liver fibrosis group, were the lowest in the moderate-severe liver fibrosis group.The HBeAg level was significantly lower than that of the mild and moderate-severe liver fibrosis group, was the highest in the moderate-to-severe liver fibrosis group(P<0.05).The results of correlation analysis showed that the degree of liver fibrosis in chronic HBV patients was positively correlated with LSM,AST/ALT and APRI,and negatively correlated with HBeAg(P<0.05).The ROC curve was used to analyze the diagnostic value of transient elastography, HBeAg, AST/ALT and APRI alone and combined detection of them for liver fibrosis in patientswith chronic HBV.The area under the four combined detection curve was the largest, which was 0.909.Conclusion Serological indicators and transient elastography technology have certain diagnostic value for liver fibrosis in patients with chronic HBV,and the combined detection of them can effectively improve the diagnostic accuracy.
作者
胥卉苹
李蔚
刘蓉
刘婷
XU Huiping;LI Wei;LIU Rong;LIU Ting(Department of Ultrasound Medicine,Wetijiang Branch of Sichuan Provincial Peopled Hospital,Chengdu 611130,China)
出处
《中国煤炭工业医学杂志》
2021年第6期659-663,共5页
Chinese Journal of Coal Industry Medicine
基金
四川省卫生与计划生育委员会基金项目(编号:190025)。
关键词
瞬时弹性成像
血清学指标
慢性乙型病毒性肝炎
肝纤维化程度
Transient elastography
Serological indicators
Chronic viral hepatitis B
Degree of liver fibrosis