摘要
目的探讨肝硬化治疗前后超声弹性成像参数、肝纤维化指标改变及临床意义。方法回顾性选取2020年4月至2022年5月绍兴文理学院附属医院收治的108例肝硬化患者,根据治疗效果分为有效组(67例)、无效组(41例),比较两组治疗前后超声弹性成像参数、肝纤维化指标水平,采用Pearson检验分析超声弹性成像参数与肝功能指标、肝纤维化指标的相关性,采用Logistic回归筛选影响疗效的危险因素,采用受试者工作特征(ROC)曲线分析肝功能指标、超声弹性成像参数、肝纤维化指标预测疗效的价值。结果有效组治疗后天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBil)水平低于治疗前,白蛋白(ALB)水平高于治疗前[(83.38±13.29)U/L比(112.84±16.07)U/L、(72.65±11.33)U/L比(90.75±12.34)U/L、(33.82±8.86)μmol/L比(41.49±9.57)μmol/L、(38.44±3.59)g/L比(33.84±4.57)g/L],差异均有统计学意义(P<0.05)。有效组治疗后肝脏硬度检测(LSM)最大值(LSMmax)、LSM最小值(LSMmin)、LSM平均值(mLSM)、肝纤维化超声半定量评分、基于4因子的纤维化指数(FIB-4)低于治疗前[20.80(12.00,31.50)kPa比26.50(15.20,35.30)kPa、4.40(3.10,8.50)kPa比6.50(3.20,9.10)kPa、14.80(10.10,25.40)kPa比20.00(13.00,30.50)kPa、(7.79±1.84)分比(10.35±2.61)分、3.11±0.36比3.65±0.48],差异均有统计学意义(P<0.05)。Pearson检验结果表明,治疗前LSMmax、LSMmin、mLSM、肝纤维化超声半定量评分与AST、ALT、TBil、FIB-4呈正相关,与ALB呈负相关(P<0.05)。Logistic回归分析结果显示,在校正了AST、ALT、TBil、ALB后,LSMmax、LSMmin、mLSM、肝纤维化超声半定量评分、FIB-4仍是影响疗效的危险因素(P<0.05)。ROC曲线分析结果显示,各项超声弹性成像参数联合预测疗效的曲线下面积(AUC)大于各项肝功能指标联合预测的AUC(P<0.05)。结论肝硬化患者治疗前后超声弹性成像参数、肝纤维化指标的改变情况与治疗效果有关,�
Objective:To investigate the changes of ultrasound elastography parameters,liver fibrosis index and clinical significance before and after cirrhosis treatment.Methods:One hundred and eight patients with cirrhosis admitted to Affiliated Hospital of Shaoxing University of Arts and Sciences from April 2020 to May 2022 were selected retrospectively and divided into effective group and ineffective group according to the treatment effect,the liver function indexes and ultrasound parameters before and after treatment were compared,the correlation between ultrasound parameters and liver function index were analyzed by Pearson test,the risk factors influencing the efficacy were analyzed by Logistic regression,ultrasound parameters,liver fibrosis index parameters to predict the efficacy value were analyzed by the receiver operating characteristic(ROC)curve.Results:The levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBil)in the effective group were decreased and the level of ALB was increased after treatment:(83.38±13.29)U/L vs.(112.84±16.07)U/L,(72.65±11.33)U/L vs.(90.75±12.34)U/L,(33.82±8.86)μmol/L vs.(41.49±9.57)μmol/L,(38.44±3.59)g/L vs.(33.84±4.57)g/L,there were statistical differences(P<0.05).The levels of liver stiffness measurement(LSM)maximum value(LSM max),minimum value(LSM min),mean value(mLSM),ultrasound semi-quantitative score,and fibrosis index based on the 4 factor(FIB-4)in the effective group after treatment were decreased:20.80(12.00,31.50)kPa vs.26.50(15.20,35.30)kPa,4.40(3.10,8.50)kPa vs.6.50(3.20,9.10)kPa,14.80(10.10,25.40)kPa vs.20.00(13.00,30.50)kPa,(7.79±1.84)scores vs.(10.35±2.61)scores,3.11±0.36 vs.3.65±0.48,there were statistical differences(P<0.05).The results of Pearson test showed that LSM max,LSM min,mLSM,ultrasound semi-quantitative scores were positively correlated with AST,ALT,TBil,FIB-4,and negatively correlated with ALB(P<0.05).The results of Logistic regression showed that after correcting for AST,ALT,TBil,ALB,the LSM max,LSM min,mLSM,
作者
孟德莉
丁凤锋
丁丰
Meng Deli;Ding Fengfeng;Ding Feng(Department of Ultrasound,Affiliated Hospital of Shaoxing University of Arts and Sciences,Shaoxing 312000,China;Department of Infectious Disease,Affiliated Hospital of Shaoxing University of Arts and Sciences,Shaoxing 312000,China)
出处
《中国医师进修杂志》
2024年第8期688-693,共6页
Chinese Journal of Postgraduates of Medicine
基金
浙江省医药卫生科技计划项目(2023KY371)。
