本文選題：彈性成像技術(shù)　切入點(diǎn)：肝硬化　出處：《中國(guó)全科醫(yī)學(xué)》2015年06期 　論文類型：期刊論文

【摘要】：背景肝纖維化是慢性肝病發(fā)展為肝硬化的可逆中間環(huán)節(jié),早期診斷和及時(shí)干預(yù)對(duì)延緩疾病進(jìn)展及改善預(yù)后極為重要。目的通過(guò)分析超聲彈性成像組織彌散定量分析和天冬氨酸氨基轉(zhuǎn)移酶(AST)與血小板計(jì)數(shù)(PLT)比值指數(shù)(APRI)、綜合評(píng)分對(duì)慢性病毒性肝炎肝纖維化的診斷價(jià)值,為無(wú)創(chuàng)診斷肝纖維化提供臨床依據(jù)。方法選取2012年2月—2013年12月在廣東省人民醫(yī)院感染科住院治療的慢性乙型肝炎患者158例,其中F1期38例(F1期組)、F2期53例(F2期組)、F3期38例(F3期組)、F4期29例(F4期組),另選取同期本院體檢的健康志愿者38例為對(duì)照組,檢測(cè)AST、丙氨酸氨基轉(zhuǎn)移酶(ALT)、γ-谷氨酰轉(zhuǎn)肽酶(GGT)、總膽紅素、PLT等血清學(xué)指標(biāo),記錄超聲彈性成像組織彌散定量評(píng)分(ES),根據(jù)公式計(jì)算APRI及綜合評(píng)分。分析APRI及綜合評(píng)分診斷肝纖維化分期的ROC曲線下面積,綜合評(píng)分截?cái)嘀导办`敏度、特異度。結(jié)果對(duì)照組與不同肝纖維化分期組患者AST、ALT、GGT、總膽紅素及PLT水平比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。F1期組、F2期組、F3期組、F4期組患者超聲彈性成像組織彌散定量分析檢測(cè)感興趣區(qū)(ROI)的應(yīng)變均值、標(biāo)準(zhǔn)偏差、藍(lán)色區(qū)域(AREA)、復(fù)雜度比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);組間兩兩比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。Spearman等級(jí)相關(guān)分析結(jié)果顯示,APRI、ES、綜合評(píng)分與肝纖維化分期均呈正相關(guān)(rs=0.646,P0.001;rs=0.739,P0.001;rs=0.830,P0.001)。APRI診斷≥F2期、≥F3期和≥F4期肝纖維化的ROC曲線下面積分別為0.86、0.88、0.89;綜合評(píng)分診斷≥F2期、≥F3期和≥F4期肝纖維化的ROC曲線下面積分別為0.93、0.95、0.92。綜合評(píng)分截?cái)嘀禐?00分時(shí),診斷≥F2期肝纖維化的靈敏度為84.6%、特異度為88.2%;綜合評(píng)分截?cái)嘀禐?00分時(shí),診斷≥F3期肝纖維化的靈敏度為91.5%、特異度為81.3%;綜合評(píng)分截?cái)嘀禐?14分時(shí),診斷≥F4期肝纖維化的靈敏度為48.2%、特異度為100.0%。結(jié)論超聲彈性成像組織彌散定量分析可較好地用于慢性病毒性肝炎肝纖維化的診斷,并且結(jié)合血清學(xué)指標(biāo)的綜合評(píng)分能夠更好地提高診斷準(zhǔn)確度。
[Abstract]:Background liver fibrosis is a reversible intermediate link in the development of chronic liver disease into cirrhosis. Early diagnosis and timely intervention are very important to delay the progress of disease and improve prognosis. Objective to analyze the quantitative analysis of tissue diffusion and the ratio of aspartate aminotransferase (AST) to platelet count (PLT). The diagnostic value of combined score in liver fibrosis of chronic viral hepatitis. Methods from February 2012 to December 2013, 158 patients with chronic hepatitis B who were hospitalized in the Department of infection in Guangdong Provincial people's Hospital were selected. Among them, there were 38 cases of F _ 1 stage in F _ 1 stage and 53 cases of F _ 2 stage in F _ 2 stage. 38 cases of F _ 3 stage group and 29 cases of F _ 4 stage F _ 4 group were selected as control group, and 38 cases of healthy volunteers were selected as control group. Serum AST, alanine aminotransferase (alt), 緯 -glutamyl transpeptidase (GGT), total bilirubin (PLT) and so on were detected. The APRI and the comprehensive score were calculated according to the formula. The area under the ROC curve, the truncation value and the sensitivity of the comprehensive score were analyzed for the diagnosis of hepatic fibrosis stage by APRI and comprehensive score. Results the levels of GGTT, total bilirubin and PLT were compared between the control group and the patients with different stages of hepatic fibrosis. The differences were statistically significant in the strain mean, standard deviation, blue region of AREAA, and complexity comparison between F _ 2 and F _ 3, F _ 3, F _ 4, F _ 4, F _ 3, F _ 3, F _ 4, P _ (0.05), F _ (1), F _ (2), F _ (3) and F _ (4) groups. The difference was statistically significant (P 0.05), the difference was statistically significant (P 0.05). Spearman grade correlation analysis showed that APRI ESS was positively correlated with liver fibrosis stage, and the comprehensive score was positively correlated with liver fibrosis stage (P 0.001 rsl 0.739P 0.001rs0.830 P 0.001P 0.001). APRI was used to diagnose 鈮，

本文編號(hào)：1598223