Abstract：Objective: To analyze the diagnostic value of liver transient elastography in the staging of liver fibrosis in patients with chronic hepatitis B (CHB) and alcoholic liver disease. Methods: A retrospective study was carried out to collect the clinical data of 67 patients with CHB and alcoholic liver disease in our hospital. All patients were examined by transient elastic ultrasound and liver biopsy. According to Ishak score, liver fibrosis was periodized. The differences of baseline data, blood biochemical indexes and liver hardness values of patients with different stages of liver fibrosis were compared. Through Spearman correlation analysis, the relationship between the liver hardness and the stage of liver fibrosis was analyzed. The receiver operating characteristic (ROC) curve of the subjects was plotted to evaluate the predictive value of liver hardness on liver fibrosis, and the sensitivity and specificity were calculated. Results: Of the 67 patients, there were 8 cases in stage 0, 15 cases in stage 1, 17 cases in stage 2, 9 cases in stage 3, 8 cases in stage 4, 7 cases in stage 5 and 3 cases in stage 6. The differences of ages, albumin, total bilirubin, alanine aminotransferase (ALT) and prothrombin activity (PTA) in different stages of liver fibrosis were statistically significant (P<0.05); the differences of gender, body mass index and aspartate aminotransferase (AST) in different stages of liver fibrosis were not statistically significant (P>0.05). There was a significant difference in the hardness of liver between the patients with different stages of fibrosis (P<0.001). The Spearman correlation analysis showed that there was a positive correlation between liver hardness and fibrosis stage (P<0.001). When the threshold value of liver hardness was 7.75 kPa, the sensitivity and specificity of liver fibrosis were 89.83% and 75.00%, respectively, and the area under ROC curve was 0.84 (P<0.001). Conclusion:Transient elastic ultrasound imaging of liver has a high diagnostic value for the degree of liver fibrosis in CHB patients with alcoholic liver disease, which is applicable in evaluating the stage of liver fibrosis in early stage.
刘品兰, 姜琳琳. 肝脏瞬时弹性超声成像对CHB合并酒精性肝病患者肝纤维化分期的诊断价值分析[J]. 河北医学, 2020, 26(6): 959-962.
LIU Pinlan, JIANG Linlin. An Analysis of the Diagnostic Value of Transient Elastography in the Staging of Liver Fibrosis in CHB Patients with Alcoholic Liver Disease. HeBei Med, 2020, 26(6): 959-962.
[1] 穆晓洁,孟繁坤.实时剪切波弹性成像在乙型肝病诊断中的应用研究[J].医学影像学杂志,2017,27(11):2131~2134. [2] 杨荟玉,孙爱民,程豪为,等.国产恩替卡韦胶囊治疗慢性乙型肝炎的随机、双盲、阳性药物平行对照临床研究[J].郑州大学学报(医学版),2017,52(5):633~637. [3] Xiao H, Shi M, Xie Y, et al. Comparison of diagnostic accuracy of magnetic resonance elastography and Fibroscan for detecting liver fibrosis in chronic hepatitis B patients: a systematic review and meta-analysis[J]. PLoS One,2017,12(11):e0186660. [4] Guo L, Zheng L, Hu L, et al. Transient elastography (FibroScan) performs better than non-invasive markers in assessing liver fibrosis and cirrhosis in autoimmune hepatitis patients[J]. Med Sci Monit,2017,23(1):5106~5112. [5] 中华医学会感染病学分会,中华医学会肝病学分会.慢性乙型肝炎防治指南(2019年版)[J].中国医学前沿杂志(电子版),2019,11(12):51~77. [6] 中华医学会肝病学分会脂肪肝和酒精性肝病学组,中国医师协会脂肪性肝病专家委员会.酒精性肝病防治指南(2018更新版)[J].中华肝脏病杂志,2018,26(3):188~194. [7] Sun Y, Zhou J, Wu X, et al. Quantitative assessment of liver fibrosis (qFibrosis) reveals precise outcomes in Ishak "stable" patients on anti-HBV therapy[J]. Sci Rep,2018,8(1):2989. [8] Tang LSY, Covert E, Wilson E, et al. Chronic hepatitis B infection: a review[J]. JAMA,2018,319(17):1802~1813. [9] Takyar V, Etzion O, Heller T, et al. Complications of percutaneous liver biopsy with Klatskin needles: a 36-year single-centre experience[J]. Aliment Pharmacol Ther,2017,45(5):744~753. [10] Nakamura Y, Aikata H, Fukuhara T, et al. Liver fibrosis assessment by FibroScan compared with pathological findings of liver resection specimen in hepatitis C infection[J]. Hepatol Res,2017,47(8):767~772. [11] Uzlova N, Mejzlikova N, Frankova S, et al. Transient elastography - role in the assessment of the liver disease development[J]. Vnitr Lek,2018,64(10):916~922. [12] 王建芳.慢性乙型肝炎患者肝纤维化诊断中瞬时弹性波扫描仪的应用[J].中国基层医药,2017,24(8):1254~1256. [13] 曹发明,张照如,王翔,等.Fibroscan测定慢性乙型肝炎患者肝硬度值与肝组织活检病理学分期的相关性研究[J].河北医学,2018,24(7):1223~1226. [14] 陈勇良,李振燕,董春娇,等.FibroTouch联合血清学指标诊断肝纤维化分期相关性分析[J].河北医科大学学报,2019,40(5):607~610.
2020, Vol. 26 
冀公网安备13080202000677号