摘要
目的探讨超声弹性成像结合血清指标评估慢性乙型肝炎患者肝纤维化的应用效果。方法选取2022年4月—2023年4月在扬州市第三人民医院肝病科确诊为显著性肝纤维化的66例慢性乙型肝炎患者为试验组,同期临床确诊为非显著性肝纤维化的66例慢性乙型肝炎患者为对照组。2组患者均行肝脏超声弹性成像检测,同时检测血清相关指标。比较2组杨氏模量值等超声弹性成像检查结果和相关血清学指标。结果肝脏超声弹性成像检测结果显示,试验组杨氏模量值(9.26±1.43)kPa、肝纤维化指数肝纤维指数(liver fibrosis index,LF Index)(2.85±1.23)水平显著高于对照组[(5.56±1.35)kPa、(2.14±0.43)],差异有统计学意义(P<0.001)。试验组肝功能指标血清透明质酸(hyaluronic acid,HA)、层粘连蛋白(laminin,LN)、Ⅳ型胶原(typeⅣcollagen,Ⅳ-C)、Ⅲ型前胶原氨基端肽水平(level of amino terminal peptide of typeⅢprocollagen,PⅢP)[(86.36±12.24)μg/L、(64.38±8.96)μg/L、(72.03±11.12)μg/L、(13.42±4.02)μg/L]水平高于对照组[(45.41±10.35)μg/L、(51.12±10.23)μg/L、(48.25±13.02)μg/L、(8.02±1.39)μg/L],差异有统计学意义(P<0.001)。试验组谷草转氨酶(glutamic oxaloacetic transaminase,AST)、谷丙转氨酶(glutamic-pyruvic transaminase,ALT),γ-谷氨酞转肽酶(γ-glutathione transdermal enzyme,GGT)、碱性磷酸酶(alkaline phosphatase,ALP)[(25.62±4.22)U/L、(33.56±3.43)U/L、(22.76±3.06)U/L、(73.92±8.63)U/L]高于对照组[(18.36±4.96)U/L、(20.36±4.23)U/L、(18.38±2.64)U/L、(52.31±10.25)U/L],差异有统计学意义(P<0.001)。试验组三酰甘油(triacylglycerol,TG)、胆固醇(cholesterol,CHOL)水平[(1.03±0.31)mmol/L、(4.33±0.52)mmol/L]低于对照组[(1.83±0.29)mmol/L、(5.02±0.38)mmol/L],差异有统计学意义(P<0.001)。结论慢性乙型肝炎患者肝纤维化存在超声弹性成像结果改变,且伴有血清指标异常变化,两者联合诊断可为肝纤维化评估与预测提供参考依据。
Objective To explore the application effect of ultrasound elastography combined with serum indicators in evaluating liver fibrosis in patients with chronic hepatitis B.Methods A total of 66 chronic hepatitis B patients diagnosed with significant liver fibrosis in the department of hepatology of the Third People's Hospital of Yangzhou from April 2022 to April 2023 were as the testing group,and 66 chronic hepatitis B patients diagnosed with non significant liver fibrosis for the same period were as the control group.Both groups of patients underwent liver ultrasound elastography and serum related indicators were tested.The results of ultrasound elastography,such as Young's modulus values and the relevant serum indicators were compared between the two groups.Results The results of liver ultrasound elastography showed that the mean Young's modulus(9.26±1.43)kPa and liver fibrosis index(LF Index)(2.85±1.23)levels in the experimental group were significantly higher than those in the control group(5.56±1.35)kPa and(2.14±0.43),with statistical significance(P<0.001).The levels of serum hyaluronic acid(HA),laminin(LN),typeⅣcollagen(Ⅳ-C),and typeⅢprocollagen amino terminal peptide(PⅢP)in the experimental group were higher than those in the control group[(86.36±12.24)μg/L,(64.38±8.96)μg/L,(72.03±11.12)μg/L,(13.42±4.02)μg/L],and the differences were statistically significant[(45.41±10.35)μg/L,(51.12±10.23)μg/L,(48.25±13.02)μg/L,(8.02±1.39)μg/L]with statistical significance(P<0.001).The levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),γ-glutathione transpeptidase(GGT),and alkaline phosphatase(ALP)in the experimental group were higher than those in the control group[(25.62±4.22)U/L,(33.56±3.43)U/L,(22.76±3.06)U/L,(73.92±8.63)U/L],and the differences were statistically significant(P<0.001).The levels of triglycerides(TG)and cholesterol(CHOL)in the experimental group(1.03±0.31)mmol/L,(4.33±0.52)mmol/L,were lower than those in the control group(1.83±0.29)mmol/L,(5.02±0.38)mmol/L,and the differences were statistically significant(P<0.001).Conclusion Chronic hepatitis B patients with liver fibrosis exhibit changes in ultrasound elastography results,accompanied by abnormal changes in serum indicators.The combined diagnosis of the two can provide a reference basis for the evaluation and prediction of liver fibrosis.
作者
曹灵芝
樊正勤
李文颖
CAO Lingzhi;FAN Zhengqin;LI Wenying(Department of Hospital Infection-Control,the Third People's Hospital of Yangzhou,Yangzhou Jiangsu 225000,China)
出处
《中国卫生标准管理》
2024年第15期5-8,共4页
China Health Standard Management
关键词
超声弹性成像
血清相关指标
联合检测
慢性乙型肝炎
肝纤维化指数
肝功能
ultrasound elastography
serum related indicators
joint testing
chronic hepatitis B
liver fibrosis index
liver function
