瞬时弹性超声成像在评价非酒精性脂肪性肝炎肝纤维化严重程度中的价值

摘要/Abstract

摘要： 目的探讨瞬时弹性超声成像在评价非酒精性脂肪性肝炎肝纤维化严重程度中的价值。方法研究对象选取成都大学附属医院2018年9月到2019年9月间收治的非酒精性脂肪性肝炎患者236例,依据肝脏穿刺纤维化程度,将全部患者分为5组,分别是A组(50例)、B组(47例)、C组(52例)、D组(44例)、E组(43例)。肝脏穿刺1周内,应用瞬时弹性超声成像对肝硬度值(LSM)进行检测。比较5组患者LSM,对LSM与肝纤维化严重程度的关系进行分析。对所有受试者操作特征(ROC)曲线进行绘制。计算评价非酒精性脂肪肝炎肝纤维化严重程度时,其曲线下面积(AUC)、特异度、灵敏度。结果 A组LSM为(5.14±1.51)kPa,B组LSM为(7.42±1.48)kPa,C组LSM为(9.34±1.63)kPa,D组LSM为(11.82±1.66)kPa,E组LSM为(13.61±1.65)kPa。5组LSM由低至高排序,依次为A组、B组、C组、D组、E组,且5组间比较,组间差异显著(P<0.05)。运用Logistic线性回归对LSM与肝纤维化分期的相关性进行分析,发现LSM与肝纤维化分期存在正相关(r=0.712),差异具有统计学意义(P=0.001)。B组、C组、D组、E组的AUC分别为0.761、0.871、0.910、0.932,诊断界值分别为6.33kPa、7.78kPa、9.14kPa、10.93kPa,特异度分别为82.4%、79.3%、95.1%、98.5%,灵敏度分别为73.1%、76.3%、88.2%、89.5%。结论瞬时弹性超声成像技术在应用于评估非酒精性脂肪性肝炎肝纤维化程度时,具有很高的应用价值,尤其应用于S3、S4期的肝纤维化,其特异度、灵敏度都较高。

关键词: 瞬时弹性超声成像, 非酒精性脂肪性肝炎, 肝纤维化

Abstract: Objective To explore the value of transient elastography in evaluating the severity of liver fibrosis in non-alcoholic steatohepatitis.Methods The research subjects selected 236 patients with non-alcoholic steatohepatitis admitted to our hospital from September 2018 to September 2019. According to the degree of liver puncture fibrosis, all patients were divided into 5 groups, which were group A (50 Cases), group B (47 cases), group C (52 cases), group D (44 cases), group E (43 cases). Liver stiffness (LSM) was detected using instantaneous elastic ultrasound imaging within 1 week of liver puncture. The LSM of 5 groups of patients was compared, and the relationship between LSM and the severity of liver fibrosis was analyzed. Draw the ROC of all patients. When calculating and evaluating the severity of non-alcoholic steatohepatitis liver fibrosis, the area under the curve (AUC), specificity and sensitivity were detected.Results Group A LSM was (5.14±1.51) kPa, Group B LSM was (7.42±1.48) kPa, Group C LSM was (9.34±1.63) kPa, Group D LSM was (11.82±1.66) kPa, Group E LSM was (13.61±1.65) kPa. The five groups of LSMs were ranked from low to high, followed by Group A, Group B, Group C, Group D, and Group E, and compared among the five groups, the difference between the groups was significant (P<0.05). Logistic linear regression was used to analyze the correlation between LSM and liver fibrosis stage, and it was found that LSM was positively correlated with liver fibrosis stage (r=0.712), and the difference was statistically significant (P=0.001). The AUC of group B, group C, group D and group E were 0.761, 0.871, 0.910, 0.932, the diagnostic cut-off values were 6.33 kPa, 7.78 kPa, 9.14 kPa, 10.93 kPa, and the specificity was 82.4%, 79.3%, 95.1%, 98.5%, and sensitivities of 73.1%, 76.3%, 88.2%, and 89.5%, respectively.Conclusion Transient elastography is of high application value when it is used to evaluate the degree of non-alcoholic steatohepatitis liver fibrosis, especially when it is applied to S3 and S4 liver fibrosis, its specificity and sensitivity are high.

Key words: Transient elastography, Nonalcoholic steatohepatitis, Liver fibrosis

郭媛, 钟毓东. 瞬时弹性超声成像在评价非酒精性脂肪性肝炎肝纤维化严重程度中的价值[J]. 肝脏, 2021, 26(1): 64-66.

GUO Yuan, ZHONG Yu-dong. The value of transient elastography in evaluating the severity of liver fibrosis in non-alcoholic steatohepatitis[J]. Chinese Hepatolgy, 2021, 26(1): 64-66.

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