超声声触诊弹性成像诊断慢性乙型肝炎患者肝纤维化价值研究*

doi:10.3969/j.issn.1672-5069.2025.03.006

摘要/Abstract

摘要： 目的探讨应用超声声触诊弹性成像(STE)评估慢性乙型肝炎(CHB)患者肝纤维化(LF)分期的价值。方法 2021年1月～2024年3月我院诊治的79例CHB患者,均接受肝活检病理学检查,依据病毒性肝炎防治方案的标准进行LF分期。使用STE技术行肝脏硬度检测(LSM),应用受试者工作特征(ROC)曲线分析指标评估LF分期的效能。结果在79例CHB患者中,经肝组织病理学检查诊断SO者17例,S1者30例,S2者15例,S3者10例和S4者7例; S2/S3期患者血清ALT和AST水平显著高于S0/S1期(P<0.05);SO、S1、S2、S3和S4者LSM分别为(6.3±0.5)kPa、(7.7±1.2)kPa、(8.9±1.4)kPa、(11.3±1.0)kPa和(15.7±1.2)kPa,呈逐步升高趋势(P<0.05);以>=S2为显著性LF,以LSM=8.3 kPa为截断点,其诊断的AUC为0.974 (95%CI:0.912~0.996),其灵敏度、特异度和准确性分别为97.1%、85.1%和94.6%。结论采用STE技术行LSM检查也可良好地诊断CHB患者LF程度,可帮助临床早期做出处理决策。

关键词: 乙型肝炎, 肝纤维化, 超声声触诊弹性成像, 肝活检, 诊断

Abstract: Objective The aim of this study was to investigate sound touch elastography (STE) in predicting liver fibrosis (LF) in patients with chronic hepatitis B (CHB). Methods 79 patients with CHB were recruited in our hospital between January 2021 and March 2024, and all of them underwent liver biopsy. Liver stiffness measurement (LSM) was obtained by STE. The receiver operating characteristic (ROC) curve was applied to evaluate diagnostic performance of LSM in predicting significant LF. Results Of 79 patients with CHB, liver histo-pathological examination showed S0 in 17 cases, S1 in 30 cases, S2 in 15 cases, S3 in 10 cases and S4 in 7 cases; serum ALT and AST levels in patients with S2/S3 were much higher than in patients with S0/S1 (P<0.05); LSM in patients with SO, S1, S2, S3 and S4 were (6.3±0.5)kPa, (7.7±1.2)kPa, (8.9±1.4)kPa, (11.3±1.0)kPa and (15.7±1.2)kPa, suggesting gradually increasing trend; the AUC was 0.974 (95%CI:0.912-0.996), with sensitivity of 97.1%, specificity of 85.1% and accuracy of 94.6%, when LSM=8.3 kPa was set as cut-off-value in predicting significant LF (defined as >=S2). Conclusion STE technique could be used in predicting LF in patients with CHB, which might add more measures for early diagnosis.

Key words: Hepatitis B, Liver fibrosis, Sound touch elastography, Liver biopsy, Diagnosis

王钰, 刘洁, 樊健敏, 王成, 叶苗青. 超声声触诊弹性成像诊断慢性乙型肝炎患者肝纤维化价值研究^*[J]. 实用肝脏病杂志, 2025, 28(3): 342-345.

Wang Yu, Liu Jie, Fan Jianmin, et al. Sound touch elastography in predicting liver fibrosis in patients with chronic hepatitis B[J]. Journal of Practical Hepatology, 2025, 28(3): 342-345.

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超声声触诊弹性成像诊断慢性乙型肝炎患者肝纤维化价值研究^*

Sound touch elastography in predicting liver fibrosis in patients with chronic hepatitis B

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