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目的探讨肝脏、脾脏剪切波速度(SWV)无创评估肝纤维化程度的临床应用价值。方法研究对象包括100例慢性乙型肝炎患者(S1~S2期61例,S3期39例、)36例肝硬化患者及39例健康对照组,采用VTQ技术测量四组肝脏、脾脏SWV。将上述参数值与病理学分期作对照研究和统计学分析。结果肝脏SWV及脾脏SWV在肝纤维化S1~S2、S3期与S4期、对照组间差异均有统计学意义(P<0.05),诊断肝S4期的肝脏SWV的ROC下面积为0.89(95%Cl:0.85~0.93),诊断的截断值为1.81 m/s,灵敏度、特异度分别为0.91%、0.84%。诊断肝S4期的脾脏SWV的ROC下面积为0.91(95%Cl:0.87~0.96),诊断截断值为2.96m/s,灵敏度、特异度分别为0.89%、0.84%。随着肝纤维化程度的加重,肝、脾SWV呈增高的趋势。结论应用VTQ技术无创测量肝脏、脾脏SWV值,二者对临床肝纤维化的诊治具有重要参考价值。
Objective To investigate the clinical value of hepatic and splenic shear wave velocity (SWV) noninvasive assessment of liver fibrosis. Methods The study included 100 patients with chronic hepatitis B (61 cases in stage S1 ~ S2, 39 cases in stage S3), 36 patients with cirrhosis and 39 healthy controls. The VTQ technique was used to measure the liver and spleen SWV in four groups. The above parameters and pathological staging for controlled study and statistical analysis. Results The liver SWV and the spleen SWV were significantly different in the control group (P <0.05). The area under the ROC for liver SWV in the liver S4 was 0.89 (95% CI, % Cl: 0.85-0.93). The diagnostic cut-off value was 1.81 m / s, and the sensitivity and specificity were 0.91% and 0.84% respectively. The area under the ROC of spleen SWV for diagnosing liver S4 was 0.91 (95% Cl: 0.87-0.96). The diagnostic cutoff was 2.96 m / s, and the sensitivity and specificity were 0.89% and 0.84%, respectively. With the aggravation of liver fibrosis, liver and spleen SWV showed an increasing trend. Conclusion The noninvasive measurement of liver and spleen SWV using VTQ technique is of great value in the diagnosis and treatment of clinical liver fibrosis.