CAJ | 학술논문

目的：评价丙氨酸氨基转移酶（ALT）轻度升高的慢性乙型肝炎病毒（HBV）感染患者瞬时弹性扫描的肝脏硬度值（Stiffness 值）与肝脏病理的相关性，了解瞬时弹性扫描在该部分人群中的临床应用价值。方法选取在四川省人民医院感染科住院行肝穿刺活组织检查的慢性 HBV 感染者110例，于肝活检手术前1周内进行瞬时弹性扫描检测 Stiffness 值，收集患者手术后的病理组织学检查结果。结果本组无肝纤维化（S0期）66例，轻度肝纤维化（S1～S2期）22例，中度肝纤维化（S3期）14例，重度肝纤维化（S4期）8例，Stiffness 值比较差异有统计学意义（P ＜0．001）。 Stiffness 值与肝纤维化分期、年龄呈正相关，与 PLT 成负相关（P ＜0．01）。肝脏彩超异常组与正常组的 Stiffness 值差异无统计学意义（P ＞0．05）。肝脏彩超异常与肝纤维化分期无相关性（P ＝0．353）。结论瞬时弹性扫描在 ALT 轻度升高的慢性 HBV 感染者的肝纤维化检测相关性较好，可作为这部分人群临床诊断肝纤维化的良好指标之一。
목적：평개병안산안기전이매（ALT）경도승고적만성을형간염병독（HBV）감염환자순시탄성소묘적간장경도치（Stiffness 치）여간장병리적상관성，료해순시탄성소묘재해부분인군중적림상응용개치。방법선취재사천성인민의원감염과주원행간천자활조직검사적만성 HBV 감염자110례，우간활검수술전1주내진행순시탄성소묘검측 Stiffness 치，수집환자수술후적병리조직학검사결과。결과본조무간섬유화（S0기）66례，경도간섬유화（S1～S2기）22례，중도간섬유화（S3기）14례，중도간섬유화（S4기）8례，Stiffness 치비교차이유통계학의의（P ＜0．001）。 Stiffness 치여간섬유화분기、년령정정상관，여 PLT 성부상관（P ＜0．01）。간장채초이상조여정상조적 Stiffness 치차이무통계학의의（P ＞0．05）。간장채초이상여간섬유화분기무상관성（P ＝0．353）。결론순시탄성소묘재 ALT 경도승고적만성 HBV 감염자적간섬유화검측상관성교호，가작위저부분인군림상진단간섬유화적량호지표지일。
Objective To evaluate the correlation between the liver stiffness values and liver pathology in chronic hepatitis B (CHB)patients with slightly increased alanine aminotransferase (ALT),and explore its diagnosis value in the population .Methods One hundred and ten CHB patients who were undergoing to do liver biopsy in department of infection disease of Sichuan Provincial People's Hospital were enrolled in the study .Fibroscan was used to detect liver stiffness in one week before surgery .At the same time, we collected the histopathologic examination results after operation .Results There were 66 cases without liver fibrosis(S0 stage),22 with mild liver fibrosis(S1 ~S2 stages),14 with moderate liver fibrosis (S3 stage)and 8 with advanced liver fibrosis (S4 stage).The difference in the stiffness values among the various stages of liver fibrosis were significant (P <0.001).The stiffness values had a posi-tive correlation with liver fibrosis stages and ages ,and a negative correlation with PLT(P <0.01).However,the liver stiffness values in patients with abnormal color Doppler ultrasonography were not different from normal subjects (P >0.05),and there was no correlation between the liver fibrosis stages and abnormal color Doppler ultrasonography (P=0.353).Conclusion There is a correlation between the stiffness values and liver biopsy pathology in CHB patients with slightly increased ALT .The fibroscan can be used as a diagnostic indicator of liver fibrosis in the population .