CAJ | 학술논문

目的：探讨实时超声弹性成像技术及天门冬氨酸转氨酶与血小板比值(APRI)诊断模型在慢性肝病早期纤维化中的临床应用价值。方法选取符合条件的90例慢性肝病患者为研究对象，行实时超声弹性成像弹性评分、蓝色区域所占百分比(实时超声弹性成像定量分析弹性参数)以及对天门冬氨酸氨基转移酶和血小板的测定并计算其比值 APRI。所有患者将于检测后1周内进行肝穿刺活检术，以病理结果为金标准，比较实时超声弹性成像弹性评分、蓝色区域所占百分比及 APRI 对慢性肝病早期肝纤维化的诊断价值。结果实时超声弹性成像弹性评分、蓝色区域所占百分比及 APRI 与纤维化病理分级呈正相关(P <0.05)。病检结果大于或等于 S1期作为早期肝纤维化的诊断标准时，实时超声弹性成像弹性评分、蓝色区域所占百分比及 APRI的受试者工作特征曲线(ROC 线)下面积分别为0.88、0.92、0.76(P <0.05)。结论实时超声弹性成像技术为诊断肝纤维化提供了新的手段，是一项具有较好应用前景的无创性超声诊断方法，联合 APRI 对慢性肝病患者早期纤维化诊断具有重要临床意义。
목적：탐토실시초성탄성성상기술급천문동안산전안매여혈소판비치(APRI)진단모형재만성간병조기섬유화중적림상응용개치。방법선취부합조건적90례만성간병환자위연구대상，행실시초성탄성성상탄성평분、람색구역소점백분비(실시초성탄성성상정량분석탄성삼수)이급대천문동안산안기전이매화혈소판적측정병계산기비치 APRI。소유환자장우검측후1주내진행간천자활검술，이병리결과위금표준，비교실시초성탄성성상탄성평분、람색구역소점백분비급 APRI 대만성간병조기간섬유화적진단개치。결과실시초성탄성성상탄성평분、람색구역소점백분비급 APRI 여섬유화병리분급정정상관(P <0.05)。병검결과대우혹등우 S1기작위조기간섬유화적진단표준시，실시초성탄성성상탄성평분、람색구역소점백분비급 APRI적수시자공작특정곡선(ROC 선)하면적분별위0.88、0.92、0.76(P <0.05)。결론실시초성탄성성상기술위진단간섬유화제공료신적수단，시일항구유교호응용전경적무창성초성진단방법，연합 APRI 대만성간병환자조기섬유화진단구유중요림상의의。
Objective To investigate the diagnostic value of the real-time tissue elastography (RTE)and AST/PLT ratio in-dex (APRI)for the assessment of the early stage liver fibrosis in chronic liver disease patients.Methods Totally 90 patients with chronic liver disease were enrolled in the present study.The RTE score and the area percentage of the blue color (AREA,one of the elastic characteristics),the AST and PLT were recorded.Compared the results among different stages of liver fibrosis reported by biopsy considered as the gold standard for the assessment of liver fibrosis.The accuracy of the diagnosis of liver fibrosis by RTE scores,AREA and APRI were compared.Results RTE scores,AREA and APRI increased with the stage of liver fibrosis. Taking ≥S1 as the diagnosis standard of the early stage liver fibrosis,the area under the curve of ROC for RTE scores,AREA and APRI were 0.88,0.92,0.76 (P <0.05).Conclusion RTE is a new and promising sonography-based noninvasive method for the assessment of hepatic fibrosis in patients with chronic liver disease.Combined RTE with APRI have great clinical significance in di-agnosing the early stage liver fibrosis in chronic liver disease patients.