关键词: 慢性乙型肝炎, 肝脏硬度检测, S指数, 肝纤维化, 诊断

Abstract: Objective The aim of this study was to explore the changes of liver stiffness measurement (LSM) and S index in patients with chronic hepatitis B (CHB) and their diagnostic performance in evaluating liver fibrosis (LF). Methods A total of 95 patients with CHB were enrolled in our hospital between June 2020 and June 2022, and all patients underwent liver biopsy. The histological activity index and fibrosis staging were evaluated by Scheuer scoring system. The ultrasonic elastography was used to detect LSM. Serum glutamyl transpeptidease (GGT), albumin (ALB) and blood platelet count (PLT) were detected and S index was calculated. The receiver operating characteristic (ROC) curves were drawn by SPSS 25.0 statistical software, and the area under the curve (AUC) was calculated to determine the diagnostic efficacy of LSM and S index for the severity of LF. Results The liver histological examination showed that out of the 95 patients with CHB, there were 66 cases with non-significant intrahepatic inflammation and 29 cases with significant liver inflammation,and there were 62 cases with liver fibrosis stage S0-S1, 19 cases with stage S2 and 14 cases with stage S3-S4; the LSM and S index in CHB patients with significant intrahepatic inflammation were (9.6±1.2)kPa and (0.9±0.2), significantly higher than [(6.7±0.8) kPa and (0.5±0.1), respectively, P＜0.05)] in patients without significant liver inflammation; the LSM and S index in patient with S3-S4 were (11.2±2.3) kPa and (1.1±0.2), significantly higher than [(8.4±1.5) kPa and (0.9±0.2), P＜0.05] in patients with S2 or [(5.7±1.1)kPa and (0.4±0.1), P＜0.05] in patients with S0-S1; the AUCs were 0.891(95%CI:0.811-0.946, P＜0.001) and 0.889(95%CI:0.808-0.944, P＜0.001) when the LSM and S index were applied to predict significant LF, with the sensitivities (Se) of 0.879 and 0.727, and the specificities (Sp) of 0.807 and 0.887; the AUCs were 0.872(95%CI:0.787-0.932, P＜0.001) and 0.807(95%CI:0.713-0.881, P＜0.001) when the LSM and S index were applied to predict the advanced LF, with the Se of 0.786 and 0.786, and the Sp of 0.938 and 0.765. Conclusion The LSM and S index are closely correlated to the severity of LF in patients with CHB, and monitoring their changes might be beneficial to evaluate the severity of LF.

Key words: Hepatitis B, Liver stiffness measurement, S index, Liver fibrosis, Diagnosis