声触诊组织量化技术对慢性乙型肝炎合并脂肪肝患者肝纤维化分级的阈值研究

摘要

目的:探讨利用声触诊组织量化技术(VTQ)测定乙型肝炎(简称乙肝)合并脂肪肝患者各级纤维化剪切波速度的阈值.方法:测定311例慢性乙肝合并脂肪肝患者(肝病组)和100例健康人(对照组)的剪切波速度值,肝病组均经肝穿刺活检,并行病理肝纤维化分级及脂肪肝含量诊断,对不同肝纤维化分级及健康人群剪切波速度值进行对比分析.结果:对照组与肝纤维化分级S0组间剪切波速度值均值差异无统计学意义(P=0.87),肝病组间剪切波速度值均值两两比较差异均有统计学意义(均P<0.05).当VTQ阈值分别为1.16、1.42、1.51、1.92m/s时,诊断肝纤维化≥S1、≥S2、≥S3、≥S4准确性、敏感度、特异度分别为87.2%、82.9%、85.7%;82.7%、76.0%、75.7%;90.5%、81.0%、81.0%;99.1%、93.0%、99.0%.结论:剪切波速度测值评估乙肝合并脂肪肝患者肝纤维化分级有较高准确性、敏感度、特异度.%Objective:To determine the threshold value of shear wave velocity for all levels of fibrosis in patients of hepatitis B with fatty liver by virtual touch quantification(VTQ). Methods:311 cases of chronic hepatitis B with fatty liver and 100 healthy people were examined to get the shear wave velocity(VTQ value). All cases had accepted liver biopsy,got the classifica-tion of liver fibrosis and the diagnosis of fatty content. All cases were divided into group S0,S1,S2,S3and S4based on grading of liver fibrosis and the control group(100 healthy cases),and their VTQ values were comparatively analyzed. Results:Multiple comparisons showed that the differences between any two staging groups of the chronic hepatitis B were statistically significant (all P<0.05),except the control group and S0(P=0.55). The VTQ threshold of 1.16,1.42,1.51 and 1.92 m/s provided high ac-curacy,sensitivity and specificity in classification of group S1,S2,S3and S4. Conclusions:The VTQ value of elastosonography can be a method for grading of liver fibrosis in patients of hepatitis B with fatty liver.