摘要
目的探讨超声弹性成像联合天冬氨酸氨基转移酶与血小板计数比值指数(APRI)对代谢相关脂肪性肝病(MAFLD)肝纤维化的诊断价值。方法选取2022年7月至2024年6月收治的163例MAFLD患者,根据基于4因子的纤维化指数(FIB-4)将不同肝纤维化程度患者分为轻度组(FIB-4<1.3)51例、中度组(FIB-41.3~2.67)63例、重度组(FIB-4>2.67)49例。所有患者接受瞬时弹性成像(TE)和实时剪切波弹性成像(SWE)检查获得肝脏硬度值和弹性模量值,基于天冬氨酸氨基转移酶和血小板水平结果计算APRI。Spearman秩相关分析肝脏硬度值、肝脏弹性模量值与肝纤维化程度的相关性。受试者工作特征(ROC)曲线分析超声弹性成像联合APRI诊断重度MAFLD肝纤维化的价值。结果重度组肝脏硬度值、肝脏弹性模量值、APRI大于中度组和轻度组,且中度组大于轻度组(P<0.05)。MAFLD患者肝脏硬度值、肝脏弹性模量值与肝纤维化程度呈正相关(rs=0.724、0.614,P<0.05)。肝脏硬度值、肝脏弹性模量值、APRI诊断重度MAFLD的曲线下面积(AUC)分别为0.808、0.869、0.828;肝脏硬度值、肝脏弹性模量值和APRI联合诊断的AUC为0.894,高于单独诊断(P<0.05)。结论肝脏硬度值、肝脏弹性模量值和APRI随着MAFLD肝纤维化程度加重而增高,超声弹性成像技术联合APRI对重度MAFLD肝纤维化具有较高诊断价值。
Objective To evaluate the diagnostic value of ultrasound elastography combined with the aspartate aminotransferase-to-platelet ratio index(APRI)for liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease(MAFLD).Methods A total of 163 MAFLD patients admitted between July 2022 and June 2024 were enrolled.Based on the Fibrosis-4 Index(FIB-4),patients were categorized into mild(n=51,FIB-4<1.3),moderate(n=63,FIB-4:1.32.67),and severe(n=49,FIB-4>2.67)fibrosis groups.All patients underwent transient elastography(TE)and real-time shear wave elastography(SWE)to measure liver stiffness and elastic modulus value.APRI was calculated based on aspartate aminotransferase and platelet levels.Spearman rank correlation analysis was used to assess the correlation between liver stiffness measurement(LSM),liver elastic modulus values,and the severity of liver fibrosis.The diagnostic performance of ultrasound elastography combined with APRI for severe MAFLD-related fibrosis was analyzed using receiver operating characteristic(ROC)curves.Results LSM,liver elastic modulus values,and APRI were higher in the severe group than in the moderate and mild groups,and higher in the moderate group than in the mild group(P<0.05).LSM and liver elastic modulus value showed positive correlations with the severity of liver fibrosis(r_(s)=0.724,0.614,P<0.05).The areas under the ROC curve(AUC)for LSM,liver elastic modulus values,and APRI in diagnosing the severity of liver fibrosis in MAFLD were 0.808,0.869,and 0.828,respectively.The combined diagnostic model of LSM,liver elastic modulus values,and APRI achieved an AUC of 0.894,which was significantly higher than that of each individual parameter(P<0.05).Conclusion LSM,liver elastic modulus values,and APRI increase with the the severity of liver fibrosis in MAFLD.The combination of ultrasound elastography and APRI demonstrates.
作者
邱燕生
谢维宁
李彩妍
李新艳
董美球
QIU Yansheng;XIE Weining;LI Caiyan;LI Xinyan;DONG Meiqiu(Department of Ultrasound Medicine,Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Foshan,Guangdong 528200,China;Department of Infectious Diseases,Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Foshan,Guangdong 528200,China;Health Management Center,Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Foshan,Guangdong 528200,China)
出处
《临床误诊误治》
2025年第24期62-68,共7页
Clinical Misdiagnosis & Mistherapy
基金
佛山市自筹经费类科技创新项目(2320001006592)。
