实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (4): 561-564.doi: 10.3969/j.issn.1672-5069.2026.04.021

• 肝硬化 • 上一篇    下一篇

超声弹性成像参数联合血清肝纤维化指标评估血吸虫病性肝病患者肝纤维化程度价值研究*

杨鸿, 赖会君, 马磊, 胡明超, 沈晓东, 张金秀   

  1. 215026 江苏省苏州市 南京中医药大学附属苏州市中医医院超声科(杨鸿,赖会君,沈晓东,张金秀);普外科(胡明超);上海交通大学医学院苏州九龙医院超声科(马磊)
  • 收稿日期:2025-12-04 出版日期:2026-07-10 发布日期:2026-07-20
  • 通讯作者: 张金秀,E-mail:sifute888@163.com
  • 作者简介:杨鸿,女,39岁,大学本科,主治医师。E-mail:szzyyyh24421@163.com
  • 基金资助:
    *南京中医药大学科研基金资助项目(编号:XZR2023088)

Evaluation of liver fibrosis by ultrasound elastography and serum liver fibrosis indexes in patients with schistosomiasis liver disease

Yang Hong, Lai Huijun, Ma Lei, et al   

  1. Department of Ultrasound, Traditional Chinese Medicine Hospital, Affiliated to Nanjing University of Chinese Medicine, Suzhou 215026, Jiangsu Province, China
  • Received:2025-12-04 Online:2026-07-10 Published:2026-07-20

摘要: 目的 探讨超声弹性成像(UE)参数联合血清肝纤维化指标诊断血吸虫病性肝病(SILD)患者肝维化程度的价值。方法 2022年10月~2025年9月我院收治的98例SILD患者,经肝穿刺活检明确肝纤维化分期,使用UE行肝脏硬度检测(LSM)并获得病灶处剪切波速度(SWV)。采用ELISA法检测血清透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)和Ⅲ 型前胶原(PCⅢ)水平,应用受试者工作特征曲线(ROC)评估各指标诊断肝纤维化的效能。结果 在98例SILD患者中,肝组织病理学检查诊断显著性肝纤维化者62例(63.3%),非显著性肝纤维化者36例(36.7%);显著性肝纤维化组LSM和SWV分别为(12.2±3.7)kPa和(1.7±0.4)m/s,均显著大于非显著性肝纤维化组【分别为(6.9±1.1)kPa和(1.2±0.3)m/s,P<0.05】; 显著性肝纤维化组血清HA和Ⅳ-C水平分别为(287.3±92.8)ng/mL和(191.6±34.4)ng/mL,均显著高于非显著性肝纤维化组【分别为(144.7±18.4)ng/mL和(82.3±15.2)ng/mL,P<0.05】; ROC分析显示,应用UE参数联合血清HA和Ⅳ-C水平评估显著性肝纤维化的AUC(0.962)、敏感度(95.2%)和特异度(86.1%)均满足临床诊断的要求。结论 UE联合血清肝纤维化指标检测能帮助临床医生初步筛查SILD患者显著性肝纤维化,值得深入尝试。

关键词: 血吸虫病性肝病, 肝纤维化, 超声弹性成像, 肝脏硬度检测, 剪切波速度, 诊断

Abstract: Objective The aim of this study was to explore the evaluation of liver fibrosis by ultrasound elastography(UE) and serum liver fibrosis indexes in patients with schistosomiasis liver disease (SILD). Methods A total of 98 patients with SILD were admitted to our hospital between October 2022 and September 2025, and all underwent liver biopsies. Liver stiffness measurement (LSM) was detected by UE, and shear wave velocity (SWV) was obtained. Serum hyaluronic acid (HA), laminin (LN), IV collagen (IV-C) and III procollagen (PCIII) levels were assayed by ELISA. Diagnostic efficacy for severity of liver fibrosis was evaluated by receiver operating characteristic (ROC) curves. Results Of 98 patients with SILD, liver histopathological examination found significant liver fibrosis (SLF) in 62 cases (63.3%)and non-SLF (NSLF) in 36 cases (36.7%); LSM and SWV in SLF group were (12.2±3.7)kPa and (1.7±0.4)m/s, both much greater than [(6.9±1.1)kPa and (1.2±0.3)m/s, respectively P<0.05] in NSLF group; serum HA and Ⅳ-C levels in SLF group were (287.3±92.8)ng/mL and (191.6±34.4)ng/mL,both much higher than [(144.7±18.4)ng/mL and (82.3±15.2)ng/mL,respectively, P<0.05] in NSLF group; ROC analysis showed that AUC(0.962), sensitivity (95.2%) and specificity (86.1%) were all met request of clinical diagnosis for SLF. Conclusion The diagnostic efficacy of UE parameters in combination with serum liver fibrosis indexes is good for screening of liver fibrosis in patients with SILD, which warrants further clinical investigation.

Key words: Schistosomiasis liver disease, Liver fibrosis, Ultrasound elastography, Liver stiffness measurement, Shear wave velocity, Diagnosis