关键词: 慢性乙型肝炎, 肝脂肪变, 肝纤维化, 超声瞬时弹性成像, 诊断

Abstract: Objective The aim of this study was to investigate ultrasonic transient elastography (TE) in predicting liver fibrosis (LF) in patients with chronic hepatitis B (CHB) and concomitant liversteatosis(LS). Methods 100 patients with CHB and LS were encountered in our hospital between January 2023 and June 2024, and all underwent MRI for proton density fat fraction (MRI-PDFF) and TE scan for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). Multivariate Logistic regression analysis was applied to evaluate risk factors for LS occurrence. Results Of the 100 patients with CHB and LS, MRI-PDFF found mild LS in 49 cases (49.0%), moderate LS in 28 cases (28.0%) and severe LS in 23 cases (23.0%); body mass index (BMI), serum triglyceride, low density lipoprotein cholesterol (LDL-C), LSMand CAP in CHB patients with severe LS were (28.8±2.2)kg/m², (3.6±0.3)mmol/L, (3.9±0.5)mmol/L, (10.5±2.0)kPa and (317.5±20.0)dB/m, all significantly higher than [(26.5±2.1)kg/m², (2.5±0.3)mmol/L, (3.3±0.4)mmol/L, (7.2±1.4)kPa and (280.5±11.4)dB/m, respectively, P<0.05] in those with moderate LS or [(23.2±2.1)kg/m², (1.8±0.3)mmol/L,(2.9±0.3)mmol/L, (6.4±0.8)kPa and (257.4±4.1)dB/m, respectively, P<0.05] in those with mild LS; multivariate Logistic regression analysis showed that BMI(OR=2.818), LDL-C(OR=2.179)and CAP(OR=1.852)were all risk factors for occurrence of LS in patients with CHB(P<0.05);incidences of significant LF in CHB patients with severe, moderate and mild LS were 69.6%, 35.7% and 10.2%, significantly different among them (P<0.05). Conclusion Application ofTE is efficacious in predicting LF in patients with CHB and LS, which might help preliminarily screening in clinical practice.

Key words: Hepatitis B, Liversteatosis, Liver fibrosis, Ultrasonic transient elastography, Diagnosis