超声检查在病毒性肝炎患者肝纤维化诊断中的应用价值

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摘要目的探讨超声检查在病毒性肝炎患者肝纤维化诊断中的应用价值。方法选取2018年1月～2019年1月我院收治的50 例病毒性肝炎患者作为研究对象，依据穿刺活检结果分为5 期：无肝纤维化到肝硬化（S0～S4）。活检组织依据炎症分为4 级（G1～G4）。比较超声指标（门静脉最大流速、胆囊壁厚度、脾脏长径、门静脉主干内径）之间的差异。结果在整个超声定性指标架构中，肝实质光点分布与形态异常、肝表面回声等指标均与炎症分级、肝纤维化分期存在紧密关联。但针对这些定性指标，其在诊断判断具体患者方面却有着比较大的差异。于各肝纤维化程度中，脾门静脉内径、脾脏长径方面有着较大差异（P＜0.05）。脾脏长径界限值为12.1 cm，对早期肝硬化进行诊断的特异性、敏感度分别为75.2%、60.0%；将脾静脉内径8 mm 当作界限值，对早期肝硬化进行诊断的特异性、敏感度分别为78.0%、60.0%；门静脉主干内径为12 mm 时，对早期肝硬化进行诊断的特异性、敏感度分别为44.5%、76.6%；如果门静脉最大流速界限值为30.5 cm/s，对早期肝硬化进行诊断的特异性、敏感度分别为66.8%、78.5%。结论在诊断病毒性肝炎肝纤维化中应用超声检查，实用且高效，临床应用价值突出。

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	谢晓琴

关键词 ：超声, 病毒性肝炎, 肝纤维化

Abstract：Objective To explore the application value of ultrasonography in the diagnosis of liver fibrosis in patients with viral hepatitis.Methods A total of 50 patients with viral hepatitis admitted to our hospital from January 2018 to January 2019 were selected as the research objects, and were divided into 5 stages according to the results of puncture biopsies：no liver fibrosis to liver cirrhosis (S0-S4).The biopsies were divided into 4 grades (G1-G4) according to inflammation.The differences in the ultrasound indicators (maximum velocity of portal vein, thickness of gallbladder wall,long diameter of spleen and inner diameter of portal vein trunk) were compared.Results In the whole ultrasonic qualitative index structure, the distribution and morphology of light spots in liver parenchyma were abnormal, and the echo of liver surface was related to the grade of inflammation.However, in view of these qualitative indexes, there was a great variation in the diagnosis and judgment of specific patients.Among the degree of liver fibrosis, there were differences in the diameter of spleen portal vein and the length of spleen (P＜0.05).The limit value of the spleen′s long diameter was 12.1 cm, and the specificity and sensitivity for the diagnosis of early cirrhosis were 75.2% and 60.0%, respectively.Taking the splenic vein inner diameter of 8 mm as the limit value, the specificity and sensitivity for the diagnosis of early cirrhosis were 78.0% and 60.0% respectively.When the limit value of inner diameter of portal vein trunk was 12 mm, the specificity and sensitivity in the diagnosis of early liver cirrhosis were 44.5% and 76.6%.If the limit value of maximum velocity of portal vein was 30.5 cm/s, the specificity and sensitivity for the diagnosis of early liver cirrhosis were 66.8% and 78.5%, respectively.Conclusion Ultrasonography is practical and efficient in the diagnosis of liver fibrosis in viral hepatitis, with outstanding clinical application value.

Key words： Ultrasound Viral hepatitis Liver fibrosis

引用本文:

谢晓琴. 超声检查在病毒性肝炎患者肝纤维化诊断中的应用价值[J]. 中国当代医药, 2020, 27(13): 134-136.
XIE Xiao-qin. Application value of ultrasonography in the diagnosis of liver fibrosis in patients with viral hepatitis. 中国当代医药, 2020, 27(13): 134-136.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I13/134

[1]	陈丽萍，强荣，杨静，等.声脉冲辐射力成像技术诊断慢性乙型病毒性肝炎患者肝纤维化的应用价值[J].临床超声医学杂志，2017，19（2）：129-131.
[2]	中华人民共和国国家卫生和计划生育委员会.中国病毒性肝炎防治规划（2017～2020年）[J].中国病毒病杂志，2018，8（1）：1-5.
[3]	Inagaki Y，Oshiro Y，Hasegawa N，et al.Clinical features of hepatitis E virus infection in Ibaraki, Japan：autochthonous hepatitis E and acute-on-chronic liver failure[J].Tohoku J Exp Med，2015，235（4）：275-282.
[4]	孟艳，隆仙琴，李杰，等.超声实时组织弹性成像定量分析对肝脏纤维化程度的诊断价值[J].中国临床研究，2017，30（11）：1549-1551.
[5]	喻红霞，申志扬，郭琦，等.声速匹配组织量化技术对慢性乙型病毒性肝炎肝纤维化的诊断价值[J].新乡医学院学报，2017，34（6）：523-525.
[6]	彭令荣，孟占鳌，王劲，等.磁共振弹力成像与扩散加权成像诊断慢性乙型病毒性肝炎纤维化程度分级的对比[J].实用医学杂志，2017，33（17）：2930-2933.
[7]	Wilhelm B，Muellner P，Pearl DL，et al.Preliminary molecular epidemiological investigation of hepatitis E virus sequences from Quebec，Canada[J].Prev Vet Med，2015，118（4）：359-369.
[8]	魏占芳，武永萍，马莉莎，等.彩色多普勒超声半定量评分对慢性乙型病毒性肝炎早期肝硬化的诊断价值[J].新乡医学院学报，2017，34（1）：47-49.
[9]	付芳芳，王梅云，史大鹏，等.多种模型MRI 扩散加权成像评估慢性乙型病毒性肝炎肝纤维化程度的价值[J].中华放射学杂志，2018，52（2）：113-118.
[10]	郭萍，张军鹏，贺继东.血清miRNA-122 检测在乙型病毒肝炎及晚期肝纤维化患者中的临床意义[J].肝胆胰外科杂志，2018，30（4）：40-44.
[11]	Holla P，Ahmad I，Ahmed Z，et al.Hepatitis E virus enters liver cells through a dynamin-2, clathrin and membrane cholesterol-dependent pathway[J].Traffic，2015，16（4）：398-416.
[12]	Shrestha AC，Faddy HM，Flower RL，et al.Hepatitis E virus：do locally acquired infections in Australia necessitate laboratory testing in acute hepatitis patients with no overseas travel history?[J].Pathology，2015，47（2）：97-100.
[13]	周林妍，李岩.FibroTouch 检测肝脏硬度与血清肝纤维化指标的相关性分析[J].中国医科大学学报，2017，46（1）：82-84.
[14]	郭璐，陈晓黎，王德欣，等.吲哚氰绿清除试验在乙型肝炎肝硬化诊断中的临床意义[J].中国医药导报，2018，15（1）：57-59，94.
[15]	何平，赵玉茹.超声弹性成像与DWI 对乙肝肝纤维化分级的临床价值比较[J].中国CT 和MRI 杂志，2017，15（9）：86-88.
[16]	董征.原发性胆汁性肝硬化与病毒性肝炎肝硬化超声诊断的对比研究[J].当代医学，2019，25（29）：105-107.