摘要
目的探讨实时剪切波弹性成像技术在评价乙型肝炎肝纤维化严重程度中的价值,并分析影响其准确性的因素。方法选择2018年2月—2020年10月成都医学院第三附属医院接诊的196例慢性乙型肝炎患者进行回顾性分析。收集患者性别、年龄、体质量指数(BMI)等人口学指标及空腹血糖、肝功能、血脂组合等实验室指标。采用实时剪切波弹性成像技术对患者进行检测,以病理学检测结果为金标准,分析实时剪切波弹性成像技术对慢性乙型肝炎肝纤维化严重程度的诊断价值,并以Logistic回归分析评估各因素对实时剪切波弹性成像诊断准确度的综合作用。结果不同严重程度乙型肝炎肝纤维化患者实时剪切波弹性成像检测值比较差异有统计学意义(P<0.05),且F0级<F_(1)级<F_(2)级<F_(3)级<F_(4)级。ROC分析结果显示:实时剪切波弹性成像对≥F1级、≥F2级、≥F3级及F4级乙型肝炎肝纤维化患者截断值分别为6.15 kPa、7.03 kPa、8.15 kPa及10.09 kPa;曲线下面积(AUC)分别为0.759、0.806、0.900、0.930(P<0.05)。单因素分析基础上多因素Logistic回归分析结果显示谷丙转氨酶(ALT)、谷草转氨酶(AST)、脂肪肝、炎症水平为影响实时剪切波弹性成像评价乙型肝炎肝纤维化严重程度准确性的独立性影响因素(P<0.05)。结论实时剪切波弹性成像技术可用于评价乙型肝炎肝纤维化严重程度,其准确性主要受ALT、AST、炎症水平及脂肪肝的影响。
Objective To explore the value of real-time shear wave elastography in evaluating the severity of liver fibrosis in hepatitis B,and to analyze the factors that affecting its accuracy.MethodsA total of 196 chronic hepatitis B patients,who admitted to the Third Affiliated Hospital of Chengdu Medical College from February 2018 to October 2020,were selected for retrospective analysis.Demographic indicators such as gender,age,body mass index(BMI),and laboratory indicators such as fasting blood glucose,liver function,and blood lipid composition were collected.The patients were detected by real-time shear wave elastography.Taking the pathological test results as the gold standard,the diagnostic value of realtime shear wave elastography in the severity of liver fibrosis in chronic hepatitis B was analyzed,and the comprehensive effect of various factors on the diagnostic accuracy of real-time shear wave elastography was evaluated by Logistic regression analysis.ResultsThe differences in real-time shear wave elastography of patients with different severity of liver fibrosis in hepatitis B were statistically significant,and F0grade1grade2grade3grade4grade (all P<0.05).ROC analysis showed that the cut-off values of real-time shear wave elastography for patients with liver fibrosis in hepatitis B≥F_(1),≥F_(2),≥F_(3)and F_(4)were6.15 kPa,7.03 kPa,8.15 kPa and 10.09 kPa respectively;the area under the curve (AUC) was 0.759,0.806,0.900 and 0.930respectively (P<0.05).Results of multivariate Logistic regression analysis based on univariate analysis showed that glutamic alanine transaminase (ALT),glutamic oxalacetic transaminase (AST),fatty liver and inflammation levels were independent factors affecting the accuracy of real-time shear wave elastography in evaluating the severity of liver fibrosis in hepatitis B (P<0.05).ConclusionsReal-time shear wave elastography technology can be used to evaluate the severity of liver fibrosis in hepatitis B,and its accuracy is mainly affected by ALT,AST,inflammation levels and fatty liver.
作者
孙小玲
何薇
李霞
褚洪毅
SUN Xiao-ling;HE Wei;LI Xia;CHU Hong-yi(Department of Ultrasound Medicine,the Third Affiliated Hospital of Chengdu Medical College(Pidu District People's Hospital of Chengdu),Chengdu,Sichuan 611730,China)
出处
《中国热带医学》
CAS
2022年第12期1169-1173,共5页
China Tropical Medicine
关键词
实时剪切波弹性成像
乙型肝炎
肝纤维化
诊断价值
多因素分析
Real-time shear wave elastography
hepatitis B
liver fibrosis
diagnostic value
multivariate analysis
