摘要
目的 分析超声弹性成像联合血清基质金属蛋白酶7(matrix metalloproteinase-7,MMP-7)、血小板比率指数(aspartate aminotransferase-to-platelet ratio index,APRI)对儿童胆道闭锁的诊断价值。方法 选取2021年2月至2023年2月成都市妇女儿童中心医院收治的70例胆道闭锁患儿作为胆道闭锁组,选取同期来院治疗的55例非胆道闭锁患儿作为非胆道闭锁组,比较两组患儿以及胆道闭锁组不同肝硬化程度患儿的生化指标、超声弹性成像肝脏硬度值(liver stiffness measurement,LSM)、MMP-7、APRI,采用Pearson相关性分析胆道闭锁患儿LSM、MMP-7及APRI的相关性。绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析超声弹性成像联合MMP-7及APRI对胆道闭锁的诊断价值。结果 胆道闭锁组谷丙转氨酶、谷草转氨酶、总胆红素、直接胆红素、LSM、血清MMP-7水平及APRI均高于非胆道闭锁组,而血小板计数低于非胆道闭锁组(P<0.05)。70例胆道闭锁患儿均存在肝纤维化,其中明显肝纤维化、轻度肝纤维化分别46例、24例,明显肝纤维化的胆道闭锁患儿谷丙转氨酶、谷草转氨酶、总胆红素、直接胆红素、LSM、血清MMP-7水平及APRI均高于轻度肝纤维化患儿,而血小板计数低于轻度肝纤维化患儿(P<0.05)。Pearson相关性分析结果显示,胆道闭锁患儿LSM与MMP-7、APRI均呈正相关,MMP-7与APRI呈正相关(P<0.05)。ROC曲线分析结果显示,LSM联合血清MMP-7、APRI诊断胆道闭锁的曲线下面积最大(0.898),敏感度、特异度、准确度分别为85.235%、81.342%、83.142%,高于各项指标单独诊断结果。结论 超声弹性成像联合血清MMP-7、APRI对儿童胆道闭锁有较高诊断价值,值得在临床应用。
Objective To analyze the diagnostic value of ultrasound elastography combined with serum matrix metalloproteinase-7(MMP-7)and aspartate aminotransferase-to-platelet ratio index(APRI)for biliary atresia in children.Method A total of 70 children with biliary atresia and 55 children without biliary atresia who were admitted to the hospital from February 2021 to February 2023 were enrolled in this study.Biochemical indicators,liver stiffness measurement(LSM),MMP-7 and APRI were compared between the two groups.These indicators in children with different degrees of liver cirrhosis were comparatively analyzed.The correlation of these indicators,and the diagnostic value of ultrasound elastography combined with serum MMP-7 and APRI for biliary atresia were analyzed.Result Alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),direct bilirubin(DBIL),LSM,serum MMP-7 and APRI in the biliary atresia group were higher than those in the non-biliary atresia group,and platelet count(PLT)was lower than that in the nonbiliary atresia group(P<0.05).In the biliary atresia group,ALT,AST,TBIL,DBIL,LSM,MMP-7 and APRI in children with severe liver fibrosis were higher than those in children with mild liver fibrosis,and PLT was lower than that in children with mild liver fibrosis(P<0.05).In the biliary atresia group,LSM was positively correlated with MMP-7 and APRI,and MMP-7 was positively correlated with APRI(P<0.05).The area under the ROC curve of ultrasound elastography combined with serum MMP-7 and APRI in the diagnosis of biliary atresia was the largest(0.898).The sensitivity,specificity and accuracy were 85.235%,81.342%and 83.142%,higher than those of single diagnosis.Conclusion Ultrasound elastography combined with serum MMP-7 and APRI is of high value in the diagnosis of biliary atresia in children.
作者
赵苏婧
杜敏
周杨
Zhao Sujing;Du Min;Zhou Yang(Ultrasound Department,Women and Children’s Hospital Affiliated to Medical College of University of Electronic Science and Technology•Chengdu Women and Children’s Central Hospital,Sichuan Chengdu 610000,China;Department of Child Digestion,Women and Children’s Hospital Affiliated to Medical College of University of Electronic Science and Technology•Chengdu Women and Children’s Central Hospital,Sichuan Chengdu 610000,China;Department of Pathology,Women and Children’s Hospital Affiliated to Medical College of University of Electronic Science and Technology•Chengdu Women and Children’s Central Hospital,Sichuan Chengdu 610000,China)
出处
《中国医刊》
CAS
2023年第11期1224-1228,共5页
Chinese Journal of Medicine
基金
成都市卫健委项目(2022094)。
关键词
超声弹性成像
基质金属蛋白酶7
血小板比率指数
儿童
胆道闭锁
诊断价值
Ultrasound elastography
Matrix metalloproteinase-7
Aspartate aminotransferase-to-platelet ratio index
Child
Biliary atresia
Diagnostic value
