标题：乙型肝炎患者二维超声、STE、血清学指标变化及其与肝纤维化分期的相关性

      作者：郑保奇，董常峰，李志艳，冯程，曾伟梅，黄琨，张瑜    深圳市第三人民医院超声科，广东 深圳 518000

      卷次： 2022年33卷16期

      【摘要】 目的 探究乙型肝炎患者二维超声、声触诊弹性成像(STE)、血清学指标变化及其与肝纤维化分期的相关性。方法 选择2019年1月至2021年4月在深圳市第三人民医院就诊的120例乙型肝炎患者作为研究组，根据患者肝纤维化病理结果分为轻度纤维化组(S1期) 43例，中-重度纤维化组(S2、S3期) 46例和肝硬化组(S4期) 31例，另选择同期在我院体检的健康者41例作为对照组。比较研究组和对照组受检者的二维超声结果以及研究组不同肝纤维化程度患者间的STE弹性值、天冬氨酸转氨酶/血小板比值指数(APRI)、纤维化4指数(FIB-4)的差异，并采用Spearman相关性分析法分析STE弹性值、APRI值和FIB-4值与肝纤维化分期的相关性。结果 二维超声结果显示，研究组患者的脾长度、脾厚度、脾静脉内径、肝门静脉内径明显长(高)于对照组，差异均有统计学意义(P<0.05)；研究组患者中，轻度纤维化组、中重度纤维化组、肝硬化组患者的STE弹性值、APRI值和FIB-4值依次升高，且不同纤维化分期患者STE弹性值、APRI值和FIB-4值比较差异均有统计学意义(P<0.05)；经Spearman相关性分析结果显示，STE弹性值(r=0.754，P<0.001)、APRI值(r=0.348，P=0.004)和FIB-4值(r=0.469，P<0.001)与肝脏纤维化分期均呈正相关。结论 二维超声、STE和血清学指标与乙型肝炎患者肝纤维化分期具有一定的相关性，可用于临床诊断分析。
      【关键词】 声触诊弹性成像；超声；乙型肝炎；肝纤维化；血清学指标
      【中图分类号】 R512.6+2 【文献标识码】 A 【文章编号】 1003—6350（2022）16—2135—04

Changes of two-dimensional ultrasound, STE, and serological indexes in hepatitis B patients and their correlationwith liver fibrosis stage.
ZHENG Bao-qi, DONG Chang-feng, LI Zhi-yan, FENG Cheng, ZENG Wei-mei, HUANG Kun,ZHANG Yu. Department of Ultrasound, Shenzhen Third People's Hospital, Shenzhen 518000, Guangdong, CHINA
【Abstract】 Objective To analyze the changes of two-dimensional ultrasound, sound touch elastography (STE)and serological indexes in hepatitis B patients and their correlation with liver fibrosis stage. Methods From January2019 to April 2021, 120 cases of hepatitis B patients admitted to Shenzhen Third People's Hospital were selected as thestudy group. According to the results of liver fibrosis staging, the patients were divided into mild fibrosis group (S1stage) with 43 cases, moderate-severe fibrosis group (S2 and S3 stage) with 46 cases, and cirrhosis group (S4 stage) with31 cases. In addition, 41 cases of healthy people examined in the hospital during the same period were collected as the con-trol group. The results of two-dimensional ultrasound were analyzed and compared between the study group and the controlgroup, and the differences in STE elasticity, aspartateaminotransferase-to-platelet ratio index (APRI), and fibrosis indexbased on the 4 factor (FIB-4) in the study group were analyzed and compared. Spearman correlation analysis was used toanalyze the correlation between STE elastic value, APRI value, and FIB-4 value and liver fibrosis stage. Results The re-sults of two-dimensional ultrasound showed that the length of spleen, thickness of spleen, inner diameter of splenic vein,and inner diameter of hepatic portal vein in the study group were significantly larger than those in the control group (P<0.05). In the study group, STE elasticity value, APRI value, and FIB-4 value increased successively in the mild fibrosisgroup, moderate-severe fibrosis group, and cirrhosis group, and there was statistically significant difference in the com-parison of STE elasticity value, APRI value, and FIB-4 value in patients with different fibrosis stages (P<0.05). Spear-man correlation analysis showed that STE elasticity value (r=0.754, P<0.001), APRI value (r=0.348, P=0.004) andFIB-4 value (r=0.469, P<0.001) were positively correlated with liver fibrosis stage. Conclusion Two-dimensional ul-trasound and STE combined with serological indexes had certain correlation with liver fibrosis staging in hepatitis B pa-tients, which can be used for clinical diagnostic analysis.
      【Key words】 Sound touch elastography; Ultrasound; Hepatitis B; Liver fibrosis; Serological indicators