摘要
目的探讨超声检查在病毒性肝炎患者肝纤维化诊断中的应用价值。方法选取2018年1月~2019年1月我院收治的50例病毒性肝炎患者作为研究对象,依据穿刺活检结果分为5期:无肝纤维化到肝硬化(S0~S4)。活检组织依据炎症分为4级(G1~G4)。比较超声指标(门静脉最大流速、胆囊壁厚度、脾脏长径、门静脉主干内径)之间的差异。结果在整个超声定性指标架构中,肝实质光点分布与形态异常、肝表面回声等指标均与炎症分级、肝纤维化分期存在紧密关联。但针对这些定性指标,其在诊断判断具体患者方面却有着比较大的差异。于各肝纤维化程度中,脾门静脉内径、脾脏长径方面有着较大差异(P<0.05)。脾脏长径界限值为12.1 cm,对早期肝硬化进行诊断的特异性、敏感度分别为75.2%、60.0%;将脾静脉内径8 mm当作界限值,对早期肝硬化进行诊断的特异性、敏感度分别为78.0%、60.0%;门静脉主干内径为12 mm时,对早期肝硬化进行诊断的特异性、敏感度分别为44.5%、76.6%;如果门静脉最大流速界限值为30.5 cm/s,对早期肝硬化进行诊断的特异性、敏感度分别为66.8%、78.5%。结论在诊断病毒性肝炎肝纤维化中应用超声检查,实用且高效,临床应用价值突出。
Objective To explore the application value of ultrasonography in the diagnosis of liver fibrosis in patients with viral hepatitis.Methods A total of 50 patients with viral hepatitis admitted to our hospital from January 2018 to January 2019 were selected as the research objects,and were divided into 5 stages according to the results of puncture biopsies:no liver fibrosis to liver cirrhosis(S0-S4).The biopsies were divided into 4 grades(G1-G4)according to inflammation.The differences in the ultrasound indicators(maximum velocity of portal vein,thickness of gallbladder wall,long diameter of spleen and inner diameter of portal vein trunk)were compared.Results In the whole ultrasonic qualitative index structure,the distribution and morphology of light spots in liver parenchyma were abnormal,and the echo of liver surface was related to the grade of inflammation.However,in view of these qualitative indexes,there was a great variation in the diagnosis and judgment of specific patients.Among the degree of liver fibrosis,there were differences in the diameter of spleen portal vein and the length of spleen(P<0.05).The limit value of the spleen′s long diameter was 12.1 cm,and the specificity and sensitivity for the diagnosis of early cirrhosis were 75.2%and 60.0%,respectively.Taking the splenic vein inner diameter of 8 mm as the limit value,the specificity and sensitivity for the diagnosis of early cirrhosis were 78.0%and 60.0%respectively.When the limit value of inner diameter of portal vein trunk was 12 mm,the specificity and sensitivity in the diagnosis of early liver cirrhosis were 44.5%and 76.6%.If the limit value of maximum velocity of portal vein was 30.5 cm/s,the specificity and sensitivity for the diagnosis of early liver cirrhosis were 66.8%and 78.5%,respectively.Conclusion Ultrasonography is practical and efficient in the diagnosis of liver fibrosis in viral hepatitis,with outstanding clinical application value.
作者
谢晓琴
XIE Xiao-qin(Department of Ultrasound,Pingxiang No.2 People′s Hospital,Jiangxi Province,Pingxiang337000,China)
出处
《中国当代医药》
2020年第13期134-136,共3页
China Modern Medicine
关键词
超声
病毒性肝炎
肝纤维化
Ultrasound
Viral hepatitis
Liver fibrosis
