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目的:探讨实时超声弹性成像(RTE)弹性评分及谷草转氨酶—血小板指数(APRI)诊断乙肝后肝纤维化程度的价值。方法:收集经病理证实肝纤维化程度的乙肝表面抗原阳性的患者79例。对79例患者行RTE检查,对所得图像进行评分,并与肝组织纤维化病理学分级及APRI对比。结果:相关分析显示肝纤维化程度与肝纤维化弹性成像弹性评分、APRI相关(r=0.721、r=0.524,均P<0.01)。肝纤维化弹性成像弹性评分诊断肝硬化的敏感度和特异度较APRI高,敏感度为71.4%,特异度89.4%,ROC曲线下面积较APRI大,为0.902。结论:实时超声弹性成像弹性评分可以对乙肝后肝纤维化程度进行初步的评定,有望成为诊断肝纤维化的无创性新方法。
Objective: To investigate the value of real-time elastography (RTE) elasticity score and aspartate aminotransferase-platelet index (APRI) in diagnosing posthepatic liver fibrosis. Methods: Totally 79 patients with HBsAg positive were confirmed by pathology. RTE was performed on 79 patients and the resulting images were scored and compared with histopathological grade of liver fibrosis and APRI. Results: Correlation analysis showed that the degree of liver fibrosis was correlated with the elasticity score of liver fibrosis, APRI (r = 0.721, r = 0.524, all P <0.01). The sensitivity and specificity of elastography for liver fibrosis elastosis in diagnosing cirrhosis were higher than those in APRI, with a sensitivity of 71.4% and a specificity of 89.4%. The area under the ROC curve was 0.902 higher than APRI. Conclusion: The real-time elastic elastography scoring can preliminarily evaluate the degree of post-hepatitis B liver fibrosis and is expected to become a new noninvasive method to diagnose hepatic fibrosis.