声触诊超声弹性成像联合超声半定量评分诊断慢性乙型肝炎患者早期肝硬化效能研究*

doi:10.3969/j.issn.1672-5069.2025.03.021

摘要/Abstract

摘要： 目的探讨声触诊超声弹性成像(STE)和超声半定量评分诊断慢性乙型肝炎(CHB)患者早期肝硬化(LC)的价值。方法 2022年1月～2024年6月我院收治的103例CHB患者,均接受肝活检,使用彩色多普勒超声行常规肝脏超声和STE检查,记录超声半定量评分和弹性模量(E)值,常规检测并计算基于4因子的肝纤维化指数(FIB-4),应用受试者工作特征曲线(ROC)分析超声各指标诊断LC的效能。结果在103例CHB患者中,肝组织病理学检查诊断早期肝硬化者37例(35.9%);LC组肝脏超声半定量总分为(13.9±1.7)分,显著高于CHB组【(8.6±1.2)分,P＜0.05】;LC组E值为(11.5±2.9)kPa,显著大于CHB组【(7.4±1.6)kPa,P＜0.05】; LC组外周血血小板计数为(112.7±41.9)×10⁹/L,显著低于CHB组【(159.6±58.3)×10⁹/L,P＜0.05】,而FIB-4评分为(2.4±0.3),显著大于CHB组【(1.5±0.6),P＜0.05】;E值联合超声半定量评分诊断CHB患者早期肝硬化的AUC为0.963(95%CI:0.906～0.990),其灵敏度为89.2%,特异度为94.5%,显著优于单一指标诊断(P＜0.05)。结论采用STE联合超声半定量评分诊断CHB患者早期LC具有很大的临床实用价值,值得临床医生总结、参考、完善、使用。

关键词: 肝硬化, 慢性乙型肝炎, 声触诊超声弹性成像, 超声半定量评分, 诊断

Abstract: Objective The aim of this study was to investigate the diagnostic performance of sound touch elastography (STE) and semi-quantitative ultrasound scoring in assessing early liver cirrhosis (LC) in patients with chronic hepatitis B(CHB). Methods A total of 103 patients with CHB were enrolled in our hospital between January 2022 and June 2024, and all underwent liver biopsies and Color Doppler ultrasonography for semi-quantitative ultrasound scores and elasticity modulus (E) values. Fibrosis index based on 4 factors (FIB-4) was routinely calculated. The diagnostic efficacy of ultrasonic indexeswas analyzed by receiver operating characteristic (ROC) curves. Results Of 103 patients with CHB, liver histo-pathological examination found early LC in 37 cases (35.9%); total score of semi-quantitative ultrasound in patients with LC was (13.9±1.7)points, much higher than [(8.6±1.2)points, P＜0.05] in patients with CHB; E value in LC group was (11.5±2.9)kPa, significantly greater than [(7.4±1.6)kPa, P＜0.05] in CHB group; peripheral blood platelet count in LC group was (112.7±41.9)×10⁹/L, much lower than [(159.6±58.3)×10⁹/L, P＜0.05], while FIB-4 score was (2.4±0.3)points, much greater than [(1.5±0.6),P＜0.05] in CHB group; the AUC was 0.963(95%CI:0.906-0.990), with sensitivity of 89.2% and specificity of 94.5%, when the E value with combination of semi-quantitative ultrasound score in predicting early LC in patients with CHB, much superior to that by any one of the parameters(P＜0.05). Conclusion STE and semi-quantitative ultrasound score have a very satisfactory diagnostic efficacy in predictingearly LC in patients with CHB, which warrant further clinical investigation.

Key words: Liver cirrhosis, Hepatitis B, Sound touch elastography, Semi-quantitative ultrasound scoring, Diagnosis

翟菲菲, 王彩, 王俊玲, 韩悦. 声触诊超声弹性成像联合超声半定量评分诊断慢性乙型肝炎患者早期肝硬化效能研究^*[J]. 实用肝脏病杂志, 2025, 28(3): 402-405.

Zhai Feifei, Wang Cai, Wang Junling, et al. Diagnostic performance of sound touch elastography and semi-quantitative ultrasound scoring in assessing early liver cirrhosisin patients with chronic hepatitis B[J]. Journal of Practical Hepatology, 2025, 28(3): 402-405.

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声触诊超声弹性成像联合超声半定量评分诊断慢性乙型肝炎患者早期肝硬化效能研究^*

Diagnostic performance of sound touch elastography and semi-quantitative ultrasound scoring in assessing early liver cirrhosisin patients with chronic hepatitis B

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