实时超声弹性成像技术及APRI对慢性肝病早期纤维化的诊断价值

发布时间：2019-03-01 17:43

【摘要】：目的探讨实时超声弹性成像技术及天门冬氨酸转氨酶与血小板比值(APRI)诊断模型在慢性肝病早期纤维化中的临床应用价值。方法选取符合条件的90例慢性肝病患者为研究对象,行实时超声弹性成像弹性评分、蓝色区域所占百分比(实时超声弹性成像定量分析弹性参数)以及对天门冬氨酸氨基转移酶和血小板的测定并计算其比值APRI。所有患者将于检测后1周内进行肝穿刺活检术,以病理结果为金标准,比较实时超声弹性成像弹性评分、蓝色区域所占百分比及APRI对慢性肝病早期肝纤维化的诊断价值。结果实时超声弹性成像弹性评分、蓝色区域所占百分比及APRI与纤维化病理分级呈正相关(P0.05)。病检结果大于或等于S1期作为早期肝纤维化的诊断标准时,实时超声弹性成像弹性评分、蓝色区域所占百分比及APRI的受试者工作特征曲线(ROC线)下面积分别为0.88、0.92、0.76(P0.05)。结论实时超声弹性成像技术为诊断肝纤维化提供了新的手段,是一项具有较好应用前景的无创性超声诊断方法,联合APRI对慢性肝病患者早期纤维化诊断具有重要临床意义。
[Abstract]:Objective to investigate the clinical value of real-time ultrasound elastography and the ratio of aspartate aminotransferase to platelet (APRI) in the diagnosis of early fibrosis in chronic liver disease. Methods A total of 90 patients with chronic liver disease were selected and evaluated by real-time ultrasonic elastography (real-time ultrasonic elastography). Percentage of blue region (quantitative analysis of elastic parameters by real-time ultrasonic elastography) and measurement of aspartate aminotransferase and platelet ratio APRI. All patients were performed liver biopsy within 1 week after the examination. According to the pathological results as the gold standard, the real-time ultrasonic elastic imaging elasticity score, the percentage of blue area and the value of APRI in the diagnosis of early hepatic fibrosis in chronic liver disease were compared. Results Real-time ultrasound elastic imaging score, percentage of blue area and APRI were positively correlated with pathological grade of fibrosis (P0.05). When the pathological examination results are greater than or equal to S1 stage as the diagnostic criteria for early hepatic fibrosis, real-time ultrasonic elastic imaging elastic score, The percentage of blue area and the area under the receiver operating characteristic curve (ROC) of APRI were 0.88,0.92 and 0.76 respectively (P0.05). Conclusion Real-time ultrasound elastography provides a new method for the diagnosis of hepatic fibrosis and is a non-invasive ultrasound diagnostic method with good application prospect. The combination of APRI and ultrasonic elastography is of great clinical significance in the early diagnosis of hepatic fibrosis in patients with chronic liver disease.
【作者单位】：重庆市黔江中心医院消化内科;重庆市黔江中心医院超声科;
【基金】：渝卫科教[2012]33号立项(2012-2-409)
【分类号】：R575

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