Abstract: Objective To investigate the correlation between the changes of liver stiffness measurements (LSM) by shear wave elastography (SWE) and serum levels of transforming growth factor β1 (TGFβ1) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in chronic hepatitis B (CHB) patients with liver fibrosis. Methods A total of 100 CHB patients with liver fibrosis admitted to the People's Hospital of Hai'an City from July 2020 to December 2022 were included in the observation group. According to the imaging and liver puncture detection results, they were divided into S0 group (n=22), S1 group (n=25), S2 group (n=23), S3 group (n=15) and S4 group (n=15) according to the degree of liver fibrosis. A total of 50 patients who underwent physical examination in our hospital during the same time period were included in the control group. The levels of LSM, serum TGF-β1 and TIMP-1 in the observation group and the control group were detected and compared. The levels of platelet technology, liver function and liver fibrosis indexes were detected and compared in each subgroup of the observation group. The correlation between LSM and TGF-β1 and TIMP-1 was analyzed by Pearson correlation analysis. Receiver operating characteristic curve (ROC) was plotted to analyze the diagnostic efficacy of LSM combined with TGF-β1 and TIMP-1 for hepatic fibrosis in CHB patients. Results The levels of LSM, TGF-β1 and TIMP-1 in the observation group were 9.32±1.82 kPa, 113.42±10.98 pg/mL and 199.08±23.56 μg/L, respectively. They were higher than 2.41±0.25 kPa, 24.53±5.64 pg/mL and 120.32±14.53 μg/L in the control group, and the differences were statistically significant (t=26.685, 53.758, 21.653, P<0.05). The levels of PLT and serum ALB in CHB patients were gradually decreased, while the levels of serum ALT, AST, γ-GT, TBil, DBil, HA, PC-Ⅲ, Ⅳ-C, LN and FIB-4 index were gradually increased with the increase of hepatic fibrosis stages. The difference was statistically significant (P<0.05). The levels of LSM, TGF-β1 and TIMP-1 in CHB patients were gradually increased with the increase of hepatic fibrosis stages, and the difference was statistically significant (P<0.05). Pearson analysis showed that LSM was positively correlated with TGF-β1 and TIMP-1 in CHB patients with liver fibrosis (rLSM vs TGF-β1=0.564, rLSM vs TIMP-1=0.587, P<0.05). The AUC, sensitivity and specificity of LSM in the diagnosis of liver fibrosis in CHB patients were 0.887, 89.70% and 85.49%, respectively, which were higher than that of serum TGF-β1 and TIMP-1 levels (0.854, 85.64%, 83.78% and 0.821, 83.05%, 80.56%). The difference was statistically significant (P<0.05). Conclusion The levels of LSM by SWE and serum TGF-β1 and TIMP-1 levels were closely correlated with the severity of liver fibrosis in CHB patients with liver fibrosis and LSM had better evaluation efficacy.

Key words: Hepatic fibrosis, SWE, LSM, TGFβ1, TIMP-1, Diagnostic effectiveness