超声剪切波弹性成像在评估乙型肝炎纤维化临床分期中的应用价值研究

Application of ultrasonic shear wave elastography in assessing clinical staging of fibrosis in patients with hepatitis B

目的探讨超声剪切波弹性成像在评估乙型肝炎纤维化临床分期中的应用价值。方法选取2020年1月~2022年1月黑龙江省医院慢性乙型肝炎患者62例,分别对其进行超声实时剪切波弹性成像检测及肝脏生化检测,并将患者的检查结果与肝脏穿刺活检病理结果进行对比分析。结果病理结果显示,参与本次研究的62例患者中,S1期10例,S2期30例,S3期22例;三期患者之间的弹性模量值均有明显的差异,且其弹性模量值随着患者的肝纤维化严重程度呈逐渐增高的趋势,差异具有统计学意义(P<0.05);慢性乙肝纤维化患者的弹性模量值与其病理分期(r=0.562,P<0.05)及其血清学指标中总胆红素(total bilirubin,TBil)、丙氨酸转氨酶(alanine aminotransferase,ALT)和门冬氨酸转氨酶(aspartate aminotransferase,AST)均呈明显的正相关(P<0.05)。结论超声实时剪切波弹性成像能够在无创检查的基础上准确、定量地评估出慢性乙型肝炎纤维化患者的纤维化临床分期。

Objective To investigate the application value of ultrasonic shear wave elastography in evaluating the clinical staging of patients with chronic hepatitis B fibrosis.Methods Sixty-two patients with chronic hepatitis B who were admitted to Heilongjiang Provincial Hospital from January 2020 to January 2022 were selected for ultrasonic shear wave elastography and liver biochemical tests,respectively.The pathological results of needle biopsy were compared and analyzed.Results The pathological results showed that among the 62 patients participating,there were 10 patients in S1 stage,30 patients in S2 stage,and 22 patients in S3 stage;There were significant differences in the elastic modulus values among patients in stage three,and its elastic modulus value gradually increased with the severity of liver fibrosis,and the difference was statistically significant(P<0.05);The elastic modulus value of patients with chronic hepatitis B fibrosis and its pathological stage(r=0.562,P<0.05),and its serological indexes total bilirubin(TBil),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)values were significantly positively correlated(P<0.05).Conclusion Ultrasonic shear wave elastography can accurately and quantitatively evaluate the clinical stage of fibrosis in patients with chronic hepatitis B on the basis of non-invasive examination.