摘要
目的探讨剪切波弹性成像技术(SWE)检查慢性乙型肝炎(CHB)肝纤维化患者肝脏硬度值(LSM)与转化生长因子β1(TGFβ1)、基质金属蛋白酶抑制因子-1(TIMP-1)的相关性。方法选择2020年7月至2022年12月海安市人民医院就诊的CHB肝纤维化患者100例列入观察组,按照肝纤维化程度分为S0组(n=22)、S1组(n=25)、S2组(n=23)、S3组(n=15)和S4组(n=15);选择同期健康体检人员50名,列入对照组。比较观察组和对照组的LSM、TGF-β1和TIMP-1水平,以及不同纤维化组的血小板、肝功能和肝纤维化指标水平。Pearson相关性分析LSM与TGF-β1和TIMP-1的相关性;受试者工作特征曲线下面积评估LSM、TGF-β1和TIMP-1对CHB肝纤维化的诊断效能。结果观察组的LSM、TGF-β1和TIMP-1水平分别为(9.32±1.82)kPa、(113.42±10.98)pg/mL和(199.08±23.56)μg/L,均高于对照组的(2.41±0.25)kPa、(24.53±5.64)pg/mL和(120.32±14.53)μg/L,差异有统计学意义(t=26.685、53.758、21.653,均P<0.05)。CHB患者的PLT和血清Alb水平随着肝纤维化分期的增加依次降低,血清ALT、AST、γ-GT、TBil、DBil、HA、PC-Ⅲ、Ⅳ-C、LN水平以及FIB-4指数随着肝纤维化分期的增加依次升高,差异有统计学意义(P<0.05)。CHB患者的LSM、TGF-β1和TIMP-1水平均随着肝纤维化分期的增加依次升高,差异有统计学意义(P<0.05)。Pearson分析显示,LSM与TGFβ1、TIMP-1均呈正相关(r=0.564、0.587,P<0.05)。LSM诊断CHB肝纤维化的AUC、敏感度、特异度分别为0.887、89.70%、85.49%,高于血清TGFβ1和TIMP-1的0.854、85.64%、83.78%和0.821、83.05%、80.56%,差异有统计学意义(P<0.05)。结论LSM、TGFβ1和TIMP-1水平与CHB患者的肝纤维化严重程度密切相关,LSM的评估效能更佳。
Objective To investigate the correlation between the changes of liver stiffness measurements(LSM)by shear wave elastography(SWE)and serum levels of transforming growth factorβ1(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±23.56μg/L,respectively.They were higher than 2.41±0.25 kPa,24.53±5.64 pg/mL and 120.32±14.53μg/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 increas
作者
陈万峰
许亚春
CHEN Wan-feng;XU Ya-chun(Department of Ultrasound,People′s Hospital of Hai′an City,Jiangsu 226600,China;Department of Radiology,People′s Hospital of Hai′an City,Jiangsu 226600,China)
出处
《肝脏》
2024年第1期50-55,共6页
Chinese Hepatology
