【摘要】 目的 通过分析影像学和实验室检查与慢性乙肝患者肝硬化临床分期的关系，探讨影像学和实验室检查对慢性乙肝患者肝硬化临床分期的价值。方法 回顾性收集2018年10月至2021年9月就诊的慢性乙肝患者240例，分别按照两期分期法和Child-Pugh评分进行分组，比较在不同的分期方法下，瞬时弹性成像测量的肝硬度值（liver stiffness measurement,LSM）、磁共振磁敏感加权成像的肝肌信号强度比（liver to muscle ratio,LMR）、纤维化-4指数（fibrosis 4 score,FIB-4）、天冬氨酸转氨酶和血小板比率指数（aspartate aminotransferase to platelet ratio index, APRI）的组间差异，分析LSM、LMR、FIB-4、APRI与不同分期方法的相关性，并绘制LSM、LMR、FIB-4、APRI判断临床肝硬化与Child-Pugh评分B级、C级的受试者工作特征曲线（receiver operating characteristic curve, ROC）。结果 使用两期分期法进行分组和Child-Pugh评分进行分组时，3组间的LSM、LMR、FIB-4、APRI均存在显著差异（P<0.05）。LSM、FIB-4、APRI与不同的分期方法均具有显著的正相关性，LMR与不同的分期方法均具有显著的负相关性（P<0.05）。使用两期法进行分组时，LSM、LMR、FIB-4、APRI判断临床肝硬化的受试者工作特征曲线下面积（area under the ROC, AUROC）分别为0.805、0.587、0.789、0.704，差异均有统计学意义（P<0.05）。使用Child-Pugh评分进行分组时，LSM、LMR、FIB-4、APRI判断Child-Pugh评分B级、C级的AUROC分别为0.924、0.691、0.921、0.940，差异均有统计学意义（P<0.05）。结论 影像学和实验室检查（LSM、LMR、FIB-4、APRI）与肝硬化临床分期密切相关，在诊断肝硬化临床分期中具有一定的价值，可以作为辅助检查帮助临床工作者更好地识别和诊断肝硬化的临床分期。更多还原

【Abstract】 Objective To explore the value of imaging and laboratory examination in clinical staging of liver cirrhosis in patients with chronic hepatitis B by analyzing the relationship between imaging and laboratory examination and clinical staging of liver cirrhosis in patients with chronic hepatitis B.Methods 240 patients with chronic hepatitis B from October 2018 to September 2021 were divided into two groups according to two-stage method and Child-Pugh score. The differences of liver stiffness measurement(LSM), magnetic resonance liver to muscle ratio(LMR), fibrosis 4 score(FIB-4), aspartate aminotransferase to platelet ratio index(APRI) measured by transient elastography were compared under different staging methods. The correlation between LSM, LMR, FIB-4, APRI and different staging methods was analyzed, and the receiver operating characteristic curve(ROC) of LSM, LMR, FIB-4, APRI to judge clinical liver cirrhosis and Child-Pugh grade B and C was drawn.Results when grouped by two-stage method and Child-Pugh score, there were significant differences in LSM, LMR, FIB-4 and APRI among the three groups(P<0. 05). LSM, FIB-4, APRI had significant positive correlation with different staging methods, while LMR had significant negative correlation with different staging methods(P<0. 05). When grouped by two-stage method, the area under the receiver operating characteristic curve(AUROC) of LSM, LMR, FIB-4and APRI for judging clinical liver cirrhosis were 0. 805, 0. 587, 0. 789 and 0. 704, respectively, and the differences were statistically significant(P<0. 05). When grouping with Child-Pugh score, the AUROC of LSM, LMR, FIB-4 and APRI according to Child-Pugh grade B and C were 0. 924, 0. 691, 0. 921 and 0. 940, respectively, and the differences were statistically significant(P<0. 05).Conclusion The imaging and laboratory examinations(LSM, LMR, FIB-4, APRI) are closely related to the clinical stage of liver cirrhosis, and have certain value in the diagnosis of clinical stage of liver cirrhosis. It can be used as an auxiliary examination to help clinical workers better identify and diagnose the clinical stage of liver cirrhosis.更多还原