摘要
目的探讨应用实时剪切波弹性成像(SWE)技术,评估肝脏弹性模量值与低病毒载量(HBV DNA≤20000 IU/mL)慢性乙型肝炎(CHB)患者肝组织病理分级的相关性。方法选取杭州师范大学附属医院2016年4月至2018年6月就诊的99例低病毒载量CHB患者,经SWE检查测定肝脏弹性模量值,行肝穿刺活组织检查病理组织学(作为金标准)进行肝脏炎症(G)分期及纤维化(S)分期。评价肝纤维化程度与肝脏弹性模量值的相关性,并采用ROC曲线评估SWE的诊断价值。结果肝脏弹性模量值在不同肝脏炎症(G)分期[(7.357±0.160),(7.425±1.267),(10.39±7.858),(14.886±1.905)kPa]与不同纤维化(S)分期[(5.855±0.109),(7.184±0.229),(8.279±0.651),(13.518±0.552),(16.267±0.463)kPa]各组间比较,除G0与G1比较差异无统计学意义(P>0.05),其余差异均有统计学意义(P<0.05)。肝脏弹性模量值与炎症活动度分级(r=0.593,P<0.05)及纤维化分期(r=0.799,P<0.05)呈中度正相关。SWE诊断肝脏炎症G≥2的ROC曲线下面积(95%CI)为0.828(0.741~0.914);诊断肝纤维化S≥2的ROC曲线下面积(95%CI)为0.906(0.847~0.966)。结论SWE可连续动态监测低病毒载量CHB患者肝组织炎症和纤维化程度。
Objective To discuss the relationship between liver elastic modulus and liver histological grade in chronic hepatitis B(CHB)patients with low viral load(HBV DNA≤20000 IU/mL)by real time shear wave elastic imaging(SWE).Methods A total of 99 CHB patients with low viral load in Hangzhou Normal University Affiliated Hospital from April 2016 to June 2018 were enrolled.SWE was performed to detect liver elastic modulus.Pathological results by liver biopsy,as the gold standard,was used to determine different stages of liver inflammation(G)and fibrosis(S).The correlation between the degree of hepatic fibrosis and liver elastic modulus were analyzed,and ROC curve was used to evaluate the diagnostic value of SWE.Results The values of elastic modulus had significant differences in different stage groups of liver inflammation(G)[(7.357±0.160),(7.425±1.267),(10.39±7.858),(14.886±1.905)kPa]and fibrosis(S)[(5.855±0.109),(7.184±0.229),(8.279±0.651),(13.518±0.552),(16.267±0.463)kPa](P<0.05),except G0 and G1 groups(P>0.05).The values of liver elastic modulus were moderately positively correlated with inflammatory activity grade(r=0.593,P<0.05)and fibrosis stage(r=0.799,P<0.05).The area under curve(95%CI)of SWE for liver inflammation G≥2 in CHB patients with low viral load was 0.828(0.741-0.914)and for liver fibrosis S≥2 was 0.906(0.847-0.966).Conclusions SWE technology can continuously and dynamically monitor the degree of liver inflammation and fibrosis in CHB patients with low viral load.
作者
陈丽
高枫
张贺彬
吴俊
潘红英
Chen Li;Gao Feng;Zhang Hebin;Wu Jun;Pan Hongying(Department of Ultrasonography,Hangzhou Normal University Affiliated Hospital,Hangzhou 310015,China;Department of Infectious Diseases,Zhejiang People's Hospital,Hangzhou 310014,China)
出处
《国际流行病学传染病学杂志》
CAS
2019年第6期481-484,共4页
International Journal of Epidemiology and Infectious Disease
关键词
肝炎
乙型
慢性
实时剪切波弹性成像
低病毒载量
肝脏炎症
肝纤维化
Hepatitis B
chronic
Real time shear wave elastography
Low viral load
Liver inflammation
Hepatic fibrosis