【摘要】 目的探讨超声量化指标对慢性乙型病毒性肝炎(乙肝)患者肝纤维化的诊断价值。方法采用超声检测448例慢性乙肝患者,并与病理诊断结果对比,确定对慢性乙肝肝纤维化的诊断价值较大的超声量化指标。结果脾脏长径、胆囊壁厚度、脾脏厚度、门静脉主干内径、脾门静脉内径5项指标与肝纤维化程度呈正相关(r值分别为0.501、0.496、0.491、0.334和0.160,P均<0.01);且肝纤维化程度不同,患者上述指标间差异有统计学意义(P<0.05),其中,脾脏长径、脾脏厚度对判断肝纤维化≥S2期尤其是≥S3期的严重肝纤维化较有诊断意义〔受试者工作特征曲线(ROC)下面积分别为0.751与0.757,0.794与0.786〕,而胆囊壁厚度对判断肝纤维化≥S3期的严重肝纤维化较有诊断意义(ROC下面积为0.804)。结论超声检测脾脏长径、脾脏厚度、胆囊壁厚度是诊断肝纤维化较有价值的指标,适用于随访复查。更多还原

【Abstract】 Objective To discuss the diagnostic value of ultrasonography(US) for detecting the severity of hepatic fibrosis in chronic hepatitis B patients.Methods 448 chronic hepatitis B patients were evaluated by US.The results of US were compared with the results of pathological diagnosis to determine the most valuable factor for diagnosing hepatic fibrosis in chronic hepatitis B patients.Results The spleen length(SPL),gall-bladder wall thickness,spleen thickness(SPT),internal diameter of portal vein and the internal diameter of splenic vein showed a positive correlation with liver fibrosis level(P<0.01),spearman correlation coefficient(r) were 0.501,0.496,0.491,0.334 and 0.160 respectively,and all these parameters showed statistics differences among patients with different hepatic fibrosis levels(P<0.05).SPL and SPT had important significance in diagnosing patients in ≥S2 stages especially in >S3(Area under receiver operating characteristic curve(AUROC) were 0.751 and 0.757,0.794 and 0.786) while gall-bladder wall thickness had important significance in diagnosing patients in ≥S3 stages(AUROC were 0.804).Conclusion SPL,SPT and gall-bladder wall thickness are valuable parameters for the diagnosis of hepatic fibrosis,and it is applicable to follow-up survey.更多还原