摘要
目的 探讨瞬时弹性成像技术(fibrotouch,FT)对乙型肝炎及自身免疫性肝病诊断效能对比价值。方法 选取我院收治的乙型肝炎患者59例(A组)、原发性胆汁性胆管炎患者31例(B组),两组均接受肝组织穿刺病理检查,获取患者病理纤维化程度分期;分别对两组进行FT检查,获得两组患者的肝硬度值(LSM),尝试分析患者LSM与病理纤维化分期的关联及差异。结果 两组患者的肝细胞炎症程度、肝组织纤维化变化基本趋于一致,Pearson分析结果显示,炎症、纤维化程度呈正相关(P<0.05);两组无纤维化、轻中度、重度纤维化患者的肝硬度值呈上升趋势,病理分期越严重,LSM越大,且不同病理分期LSM差异有统计学意义(t=234.599,321.819;均P<0.001);两组患者LSM:A组无纤维化、中轻度及重度纤维化患者LSM均低于B组,其中S0分期差异无统计学意义(t=1.780;P=0.079);S1~S2、S3~S4分期差异具有统计学意义(t=8.352,6.392;P<0.001)。结论 FT为无创、定量评估肝病患者肝脏纤维化程度的有效方式,为临床诊治提供科学依据;肝纤维化程度越高则FT检查提示LSM越高;同一病理分期下,乙型肝炎、原发性胆汁性胆管炎患者LSM存在差异;后续可尝试构建不同类型肝炎患者FT检查肝脏损伤程度参考标准。
Objective To explore the comparative value of transient elastography(FT)in the diagnosis of hepatitis B and autoimmune liver disease.Methods A total of 59 patients with hepatitis B(Group A)and 31 patients with primary biliary cholangitis(Group B)admitted to our hospital were selected.Patients of both groups underwent liver biopsy and pathological examination to obtain the stages of fibrosis;FT examination was performed on patients of two groups to obtain the liver stiffness value(LSM)of patients of the two groups,and an attempt was made to analyze the correlation and difference between the liver stiffness value and the stage of pathological fibrosis. Results The degree of hepatocyte inflammation and liver fibrosis in patients of the two groups tended to be consistent. Pearson analysis showed that there was a positive correlation between the degree of inflam-mation and fibrosis (P<0.05);The liver hardness values of patients with no fibrosis, mild to moderate, and severe fibrosis in the two groups showed an upward trend. The more severe the pathological stage was, the greater the LSM was, and the difference in LSM among different pathological stages was statistically significant (t=234.599,321.819 both P<0.001);LSM of patients with-out fibrosis, moderate to mild and severe fibrosis in Group A was lower than that in Group B, with no statistically significant dif-ference in S0 stage (t=1.780;P=0.079);The difference between S1~S2 and S3~S4 stages was statistically significant (t=8.352, 6.392;P<0.001). Conclusion FT is an effective noninvasive and quantitative method for assessing the degree of liver fibrosis in patients with liver diseases, providing scientific basis for clinical diagnosis and treatment;The higher the degree of liver fibro-sis, the higher the LSM is indicated by FT examination;Under the same pathological stage, there are differences in LSM be-tween patients with hepatitis B and primary biliary cholangitis;In the future, we can try to establish a reference standard for liver damage in FT examination of patients with different types of hepatitis.
作者
王国英
宋彦莉
刘超
李培
王敏
WANG Guoying;SONG Yanli;LIU Chao;LI Pei;WANG Min(Department of function division,Handan Infectious Diseases Hospital,Handan 056000,China;Department of gastroenterology,Hebei Qinhuangdao Second Hospital,Qinhuangdao 066600,China;Department of gastroenterology,Hebei Handan Central Hospital,Handan 056000,China;Department of Ultrasound,People's Hospital of Zhengding County,Shijiazhuang 050800,China;Department of Ultrasound,Hebei Xingtang County People's Hospital,Shijiazhuang 050600,China)
出处
《医学影像学杂志》
2024年第4期69-72,共4页
Journal of Medical Imaging
基金
河北省中医药管理局科研计划项目(编号:2022316)。
关键词
瞬时弹性成像技术
乙型肝炎
病理纤维化分期
超声检查
Instantaneous elastic imaging technology
Hepatitis B
Staging of pathological fibrosis
Ultrasound
作者简介
王国英(1974-),女,本科学历,副主任医师,主要从事超声医学诊断工作;通信作者:宋彦莉,E-mail:tys198003@126.com。
