| 摘要: |
| 目的：探讨剪切波弹性成像(shear wave elastography, SWE)测量肝脏硬度评估肝功能Child-Pugh分级的价值。方法：共85例肝硬化患者根据Child-Pugh分级分为3组：A组(5-6分)(n=35)、B组(7-9分)(n=28)、C组(10-15分)(n=22)；所有患者均行常规超声成像和SWE；分析SWE测量的肝硬度、血生化指标在评估Child-Pugh分级中的价值；绘制受试者肝脏特征曲线(ROC)评估各参数对Child-Pugh分级的诊断效能。结果：SWE测量的肝脏硬度随Child-Pugh分级、门静脉和脾静脉内径、脾脏厚度和长度、总胆红素水平(TBil)、凝血酶原时间(PT)的升高而增加,这些指标均与Child-Pugh分级呈正相关(均P <0.05)；白蛋白(ALB)水平和肝脏硬度相比其他参数评估Child-Pugh分级具有更高的曲线下面积(AUC)；白蛋白(ALB)和胆碱酯酶(ChE)水平与Child-Pugh分级呈负相关(P <0.05)。B组和C组肝门静脉内径、PT、TBil、ChE水平之间差异无统计学意义(P> 0.05),A组和C组脾脏厚度和长度、门静脉和脾静脉内径之间差异无统计学意义(P> 0.05),其余指标在各组间比较均有统计学差异(P <0.05)。3组之间丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和球蛋白(GLB)水平比较差异无统计学意义(P> 0.05)。结论：SWE测量的肝脏硬度在评估肝功能Child-Pugh分级中具有重要价值,有助于评估肝硬化患者的肝功能。 |
| 关键词: Child-Pugh分级 弹性成像 肝硬化 肝功能 剪切波弹性成像 硬度 |
| DOI： |
| 投稿时间：2019-09-02修订日期：2019-09-02 |
| 基金项目:江苏省卫生计生委2016年度面上科研课题（H201610） |
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| Clinic Value of Liver Stiffness Measured by ShearWave Elastography for Child-Pugh Classification |
| Gao Bo,Yu Xiaochang,Fu Xiaoming |
| (Ultrasound Department of Radiology,Nanjing Gulou Hospital,Gaochun Branch,Jiangsu Gaochun) |
| Abstract: |
| Objectives: To explore the value of liver stiffness for the Child-Pugh classification of liver function by shear wave elastography (SWE). Methods: A total of 85 patients with liver cirrhosis were divided into 3 groups according to the Child-Pugh classification prospectively: group A(score 5-6)(n=35)、group B(score 7-9)(n=28)、group C(score 10-15)(n=22); Conventional ultrasound imaging and SWE were performed for all patients. The associations of liver stiffness measured by SWE with ultrasound measurements, serum biochemical indicators, and the Child-Pugh classification were analyzed. Receiver operating characteristic curves were analyzed and compared to determine the ability of liver stiffness to diagnose cirrhosis. Results: Liver stiffness measured by SWE increased with an increasing Child-Pugh classification, internal diameter of the hepatic portal and splenic veins, spleen thickness, spleen length, total bilirubin level, and prothrombin time, which were positively correlated with the Child-Pugh classification (all P< 0.05). The albumin level and liver stiffness showed higher areas under the curve in comparison with other parameters for evaluating the Child-Pugh classification. Albumin and cholinesterase levels were negatively correlated with the Child-Pugh classification (P< 0.05). All of these indicators were significantly different between each pair of groups (all P< 0.05), except for the internal diameter of the hepatic portal vein, prothrombin time, and total bilirubin, and cholinesterase levels between groups B and C (P> 0.05) and the thickness and length of spleen and internal diameter of the splenic vein between groups A and B (P > 0.05). There were no differences among the groups for alanine aminotransferase, aspartate aminotransferase, and globulin levels. Conclusions: Liver stiffness measured by SWE had important value for Child-Pugh classification, and it may be able to help evaluate liver function in patients with cirrhosis. |
| Key words: Child-Pugh classification elastography hepatobiliary liver cirrhosis liver function shear wave elastography stiffness |
