关键词: 超声瞬时弹性成像, 全身免疫炎症指数, 预测, 自身免疫性肝炎, 肝硬化

Abstract: Objective To analyze the value of ultrasonic transient elastography combined with systemic immunoinflammatory index (SII) in the prediction of cirrhosis in autoimmune hepatitis (AIH) patients. Methods The levels of platelet count (PLT), neutrophil count (NEUT) and lymphocyte count (LYM) in pre-treatment blood routine examination were collected from 85 patients with AIH admitted from January 2022 to August 2023. The values of SII were calculated, and the liver stiffness measurements (LSM) before treatment were detected by ultrasonic instantaneous elastography. Patients were given routine interventions such as immunosuppressants, appropriate exercise, and diet conditioning. The patients were divided into a cirrhosis occurrence group and a non-occurrence group according to whether they had the occurrence of cirrhosis. The basic data of patients with and without AIH were compared to analyze the affecting factors for the occurrence of cirrhosis in AIH patients and the efficacy of ultrasound instantaneous elastic imaging combined with SII in predicting the occurrence of cirrhosis in AIH patients. Results Among the 85 AIH patients, 22 cases (25.88%) had cirrhosis, whereas 63 cases (74.12%) did not. The ratio of Child-Pugh grade C (72.73%, 16/22), the levels of TBIL (84.25±7.26) μmol/L, SII (2011.62±124.58) ×10⁹/L, LSM (12.63±1.74) kPa in the occurrence group were higher than those of 38.10% (24/63), (59.63±6.57) μmol/L, (1338.95±108.74)×10⁹/L, (8.29±1.47) kPa in the non-occurrence group by (P<0.05). Binary Logistic regression analysis showed that Child-Pugh grade C, TBIL, SII and LSM were the influencing factors for cirrhosis in AIH patients (P<0.05). According to ROC curve analysis, The sensitivities of Child-Pugh grade C, TBIL, SII and LSM, and the joint assessment was 68.18%, 72.73%, 77.27%, 72.73% and 90.91%, respectively. The specificity was 68.25%, 73.02%, 74.60%, 71.43% and 88.89%, respectively. The combination of Child-Pugh grade C, TBIL, SII and LSM had a higher value in predicting cirrhosis in AIH patients (P<0.05). Conclusion Child-Pugh grade C, TBil, SII and LSM are associated with cirrhosis in AIH patients, and the combined evaluation is effective for cirrhosis in AIH patients.

Key words: Ultrasonic instantaneous elastic imaging, Systemic immune inflammatory index, Forecast, Autoimmune hepatitis, Liver cirrhosis