摘要
目的:探究剪切波弹性成像(SWE)参数联合γ-谷氨酰转移酶(GGT)、谷草转氨酶(AST)/丙氨酸氨基转移酶(ALT)对肝硬化患者病情程度的评估价值。方法:选取2022年1月至2024年10月大方县人民医院收治的肝硬化患者96例,根据Child-Pugh分级分为对照组(n=65例,Child-Pugh分级A、B级)和观察组(n=31例,Child-Pugh分级C级)。肝硬化患者均接受SWE检查,检测肝硬化患者血清GGT水平、AST/ALT。比较两组SWE参数(剪切波速度、弹性模量)和血清GGT水平、AST/ALT,应用Pearson相关性分析SWE参数、血清GGT、AST/ALT与肝硬化病情程度的相关性。采用受试者工作特征(ROC)曲线分析SWE参数、血清GGT、AST/ALT单独及联合评估Child-Push C级肝硬化价值。采用Delong检验比较SWE参数联合、血清GGT和AST/ALT联合以及SWE参数和血清GGT、AST/ALT联合评估Child-Push C级肝硬化的ROC曲线下面积(AUC)。结果:与对照组比较,观察组剪切波速度较快,弹性模量较高(P<0.05);剪切波速度、弹性模量单独及联合评估的AUC分别为0.712、0.739、0.845;与对照组比较,观察组血清GGT、AST、ALT水平和AST/ALT均较高(P<0.05);血清GGT、AST/ALT单独及联合评估的AUC分别为0.664、0.714、0.790;SWE参数、血清GGT水平、AST/ALT与肝硬化病情程度呈正相关(P<0.05);SWE参数联合血清GGT、AST/ALT评估的AUC为0.923,明显高于SWE参数联合及血清GGT、AST/ALT联合(z=2.731、2.924,P均<0.05)。结论:肝硬化病情程度更重的患者其剪切波速度较快,弹性模量较高,血清GGT、AST/ALT较高,联合检测上述指标在评估肝硬化病情程度方面具有良好应用价值。
Objective:To explore the evaluation value of shear wave elastography(SWE)parameters combined with gamma-Glutamyltransferase(GGT)and aspartate aminotransferase(AST)/alanine aminotransferase(ALT)for the severity of cirrhosis patients.Methods:96 cirrhosis patients who were admitted to Dafang County People's Hospital from January 2022 to October 2024 were selected,they were divided into control group(n=65,Child-Push A and B-grade)and an observation group(n=31,Child-Push c-grade)according to Child-Push grade.All cirrhosis patients underwent SWE examination,serum GGT levels,AST/ALT in cirrhosis patients were detected.SWEparameters(shear wave velocity,elastic modulus)and serum GGT levels,AST/ALT were compared between two groups,Pearson correlation analysis was applied to investigate the correlation between SWE parameters,serum GGT,AST/ALT,and the severity of cirrhosis.The receiver operating characteristic(ROC)curve was used to analyze the value of SWE parameters,serum GGT,AST/ALT individual and combined assessment for evaluating Child-Push c-grade cirrhosis.Delong test was used to compare the area under the ROC curve(AUC)of SWE parameter combination,serum GGT and AST/ALT combination,and SWE parameter and serum GGT,AST/ALT combination in evaluating Child-Push c-grade cirrhosis.Results:Compared with the control group,the observation group had faster shear wave velocity and higher elastic modulus(P<0.05).The AUC values of shear wave velocity and elastic modulus individual and combined assessment were 0.712,0.739,and 0.845,respectively.Compared with the control group,the observation group had higher serum GGT,AST,ALT levels,and AST/ALT(P<0.05).The AUC values of serum GGT,AST/ALT individual and combined assessment were 0.664,0.714,and 0.790,respectively.SWE parameters,serum GGT levels,AST/ALT were positively correlated with the severity of cirrhosis(P<0.05).The AUC of SWE parameter combined with serum GGT and AST/ALT assessment was 0.923,significantly higher than SWE parameter combined and serum GGT and AST/ALT combined(z=2.731,2.924,both P<0.05).Conclusion:Patients with more severe cirrhosis has a faster shear wave velocity,higher elastic modulus,and higher serum GGT levels and AST/ALT.The combined detection above indicators has good application value in evaluating the degree of cirrhosis.
作者
萧德会
王云
罗娅
XIAODe-hui;WANG Yun;LUO Ya(Department of Ultrasonography,Dafang County People's Hospital,Bijie,Guizhou,551600,China;Department of Gastroenterology,Dafang County People's Hospital,Bijie,Guizhou,551600,China;Department of Laboratory,Dafang County People's Hospital,Bijie,Guizhou,551600,China)
出处
《现代生物医学进展》
2025年第13期2208-2215,共8页
Progress in Modern Biomedicine
作者简介
萧德会(1972-),女,本科,副主任医师,主要研究方向:超声医学,E-mail:18984468109@163.com。
