摘要
目的:探讨实时二维剪切波弹性成像(2D-SWE)技术评估安络化纤丸治疗慢性乙型肝炎(CHB)肝纤维化患者的临床意义。方法:选取2015年10月至2016年12月在河南中医药大学第一附属医院就诊的CHB伴肝纤维化患者110例,均行肝脏2DSWE及彩色多普勒超声引导下进行经皮肝脏穿刺组织活检术,肝纤维化的诊断以病理结果为"金标准"。随机将110例CHB患者分为两组,对照组(A组)55例,给予恩替卡韦常规抗病毒治疗,治疗组(B组)55例,在对照组用药的基础上给予安络化纤丸治疗。对照分析两组患者治疗前后肝脏弹性模量值、肝纤维化指标血清透明质酸(HA)、层黏连蛋白(LN)、IV型胶原(IV-C)水平的变化以及肝穿活组织病理检查结果。结果:两组患者治疗前肝脏弹性模量值、肝纤维化指标比较均无显著性差异(P>0.05);B组患者治疗后与治疗前相比差异有统计学意义(P<0.05),与A组相比亦有显著性差异(P<0.05),两组治疗前后肝脏穿刺活检组织学均有改善。结论:2D-SWE技术可定量检测肝脏硬度,是一种可靠、无创的评估肝纤维化的诊断方法,安络化纤丸可有效改善患者肝脏硬度和肝纤维化指标,值得在临床推广和应用。
Objiective To explore the clinical meaning of real-time two-dimensional shear wave elastography in evaluating Fibroscan of Anluohuaxan capsule on hepatic fibrosis of chronic hepatitis B patients. Merhods One hundred and ten patients with chronic hepatitis B at The First Affiliated Hospital of Henan University of traditional Chinese Medicine from October 2015 to December 2016 were examed by 2 D-SWE and color Doppler ultrasound guided aspiration biopsy,pathology results as the gold standard. Then all patients were randomly divided into contral group（ n = 55,group A） and treatment group（ n = 55,group B）. Group A was given Entecavir for conventional antiviral therapy.And group B was treated with Anluohuaxan capsule based on the group A. The elastic modulus of liver and the levels of serum HA,LN,IVC were compared before and after treatment in the two groups and comparison of changes in liver biopsy results. Results The difference of elastic modulus of liver and hepatic fibrosis in the two groups shows no statistically significance before treatment（ P 0. 05）. There was statistically significance in the elastic modulus of liver and the levels of serum HA,LN,IV-C between before and after treatment in group B（ P 0.05）. And there was a statistically significance difference between group A and B（ P 0. 05）. Histological examination of liver biopsy was improved before and after treatment in the 2 groups. Conclusion 2 D-SWE technique could quantitatively measure liver stiffness,it was a noninvasive and reliable diagnostic method for evaluating liver fibrosis. Anluohuaxan capsule could efficiently improve the elastic modulus of liver and the index of hepatic fibrosis,so it deserves further promotion and application in clinic.
出处
《中西医结合肝病杂志》
CAS
2017年第6期371-373,I0005,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
关键词
弹性成像
剪切波
乙型肝炎
肝纤维化
安络化纤丸
Elastography, shear wave
Hepatitis B
Hepatic fibrosis
Anluohuaxan capsule
