关键词: 慢性乙型肝炎, 肝纤维化, 瞬时弹性成像, 门静脉血流动力学, 诊断

Abstract: Objective To investigate the efficacy of hemodynamic indexes of portal vein and liver stiffness measure（LSM） in diagnosis of liver fibrosis in patients with chronic hepatitis B（CHB）. Methods A total of 91 patients with CHB and 41 healthy persons were recruited in this study. All subjects were examined by Fibroscan-502 to obtain the LSM,and color Doppler ultrasound were applied for the detection of inner diameters of portal vein（PVD）,max blood flow velocity of portal vein（PVVmax） and mean blood flow velocity of portal vein （PVVmean）. All CHB patients underwent liver biopsy for evaluation of liver fibrosis staging. Results The LSM, PVD, PVVmax and PVVmean in patients with CHB[（9.40±0.95） kPa,（11.63±0.12） mm,（35.40±0.94） cm/s and （29.82±0.84）cm/s] were much higher than those in healthy persons [（4.45±0.20） kPa,（10.85±0.12） mm, （26.10±1.07） cm/s and（21.94±0.73） cm/s,respectively,P<0.01];the LSM,PVD,PVVmax and PVVmean in patients with S0 fibrosis were（5.46±0.33） kPa,（11.36±0.24） mm,（40.99±1.46） cm/s and （34.42±1.29） cm/s, in patients with S1 were（6.06±0.31） kPa,（11.33±0.16） mm,（34.09±1.43） cm and（28.90±1.31） cm/s,in patients with S2 were （9.87±1.15） kPa,（12.14±0.31） mm,（33.51±1.59） cm/s and（27.78±1.73） cm/s,in patients with S3 were （15.48±2.16） kPa,（12.42±0.26） mm,（33.01±2.11） cm/s and（28.48±2.05） cm/s,and in patients with S4 were（31.85±8.38） kPa,（12.50±0.34） mm,（28.42±2.78） cm/s,and（24.58±2.91） cm/s,significantly different among the five groups（F=29.13,F=4.52,F=5.98 and F=4.36,P<0.01）;the correlations between LSM and PVD,PVVmax,and PVVmean in patients with CHB were statistically significant （r=0.362,r=-0.364,r=-0.345,P<0.01）. Conclusions The combination detection of hemodynamic indexes of portal vein and LSM of liver may be valuable in determining liver fibrosis in a noninvasive way in patients with CHB.

Key words: Chronic hepatitis B, Liver fibrosis, Transient elastography, Portal vein hemodynamics, Diagnosis