应用肝脏硬度检测联合多普勒超声检测门静脉血流动力学指标评估慢性乙型肝炎患者肝纤维化效能研究*

doi:10.3969/j.issn.1672-5069.2023.04.007

Abstract

Abstract: Objective The aim of this study was to explore the evaluation of liver fibrosis by liver stiffness measurement (LSM) and portal vein hemodynamic index combination in patients with chronic hepatitis B (CHB). Methods A total of 96 patients with CHB confirmed by liver biopsy and 74 healthy individuals were enrolled in our hospital between December 2018 and October 2022, the LSM was detected by FibroTouch scan and the portal vein diameter (PVD), maximum flow velocity (Vmax) and average flow velocity (Vmean) of portal veins were detected by ultrasonography. The diagnostic performance was evaluated by the receiver operating characteristic (ROC) curves. Results The LSM, PVD, Vmax and Vmean in patients with CHB were (9.5±1.6) kPa,(12.7±2.1) mm,(35.4±3.1)cm/s and (29.8±2.8) cm/s, all significantly greater than [(4.4±0.5)kPa, (10.7±1.6)mm,(26.1±2.5)cm/s and (21.7±2.2)cm/s, respectively, P<0.05] in healthy persons; the liver histopathological examination showed non-significant liver fibrosis in 32 cases and significant liver fibrosis in 64 cases in our series; the LSM and the PVD in patients with significant liver fibrosis were (14.5±2.6)kPa and (13.3±2.3) mm, both significantly greater than [(5.8±0.8)kPa and (11.2±1.8)mm, respectively, P<0.05], while the Vmax and Vmean of portal vein blood flow were (29.1±2.6)cm/s and (24.2±1.9)cm/s, both significantly slower than [(36.9±3.8)cm/s and (30.6±2.7)cm/s, respectively, P<0.05] in those without significant liver fibrosis; the ROC analysis showed that the diagnostic efficacy was superior to LSM or PVD alone prediction, with the sensitivity of 90.1％ and the specificity of 77.4%, when the two parameters were combined to assess the significant liver fibrosis in patients with CHB, with the LSM equal to 9.5 kPa and the PVD equal to 12.0 mm as the cut-off-value(P<0.05). Conclusion The validation of combination of LSM by FibroTouch and PVD by ultrasonography in assessing significant liver fibrosis in patients with CHB might be helpful in clinical practice.

Key words: Hepatitis B, Liver fibrosis, Liver stiffness measurement, Portal vein hemodynamic index, Diagnosis

Zhou Keli, Lyu Xiaoli, Zhou Yang, et al. Concordance between liver biopsy,and the liver stiffness measurement and hemodynamic index combination for the diagnosis of hepatic fibrosis in patients with chronic hepatitis B[J]. Journal of Practical Hepatology, 2023, 26(4): 480-483.

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Concordance between liver biopsy,and the liver stiffness measurement and hemodynamic index combination for the diagnosis of hepatic fibrosis in patients with chronic hepatitis B

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