临床外科杂志 ›› 2019, Vol. 27 ›› Issue (8): 652-654.doi: 10.3969/j.issn.1005-6483.2019.08.007

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肝脏硬度直接测定对肝硬化病理变化程度评估的价值

  

  1. 430030 武汉,华中科技大学同济医学院附属同济医院肝脏外科中心(李剑、张二雷、古今、王文强、黄志勇);湖北民族大学附属民大医院肝胆胰外科(李剑);武汉市普仁医院肝胆外科(张李威)
  • 出版日期:2019-08-20 发布日期:2019-08-20
  • 通讯作者: 黄志勇,Email:zyhuang126@126.com

The value of direct measurement of liver stiffness in evaluating the pathological severity of liver cirrhosis

  1. Department of Hepatic Surgery Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China
  • Online:2019-08-20 Published:2019-08-20

摘要: 目的 探讨肝脏硬度直接测定对乙肝后肝硬化病理变化程度评估的价值。方法 采用邵氏硬度计直接测定因肝脏外科疾病而手术的113例病人的肝脏硬度。据肝脏硬度值(liver stiffness value,LSV)的分布范围将肝脏硬度分为Ⅰ级(LSV:2~6HC)、Ⅱ级(LSV:7~11HC)和Ⅲ级(LSV:12~16HC)。对其中76例乙肝相关的肝癌病人及门静脉高压症病人肝硬化程度以Laennec分级标准进行分级,分析肝脏硬度值与肝硬化病理分级之间的相关性。结果 肝脏硬度值与肝硬化病理分级之间存在相关性(r=0.693,P<0.05),肝脏硬度值评估轻度、中度和重度肝硬化的AUC分别为0.91、0.81 和0.80。结论 肝脏硬度值与肝硬化病理改变程度之间呈明显正相关性,肝脏硬度值可以作为判断肝硬化病理程度的有效指标。

关键词: 肝脏硬度, 肝脏硬度分级, 肝硬化病理分级, Laennec分级

Abstract: Objective To explore the value of direct measurement of liver stiffness in evaluating the pathological severity hepatitis B related cirrhosis.Methods The liver stiffness of 113 patients with various kinds of surgical liver diseases was measured directly by Shaw’s sclerometer.Based on the distribution of liver stiffness value(LSV),liver stiffness is divided into three grades, grade Ⅰ(LSV:2 to 6HC),grade Ⅱ(LSV:7 to 11HC),grade Ⅲ(LSV:12 to 16HC).The severity of liver cirrhosis of 76 patients with hepatitis B background was pathologically evaluated using the Laennec staging system,and the correlation between LSV and pathological grade of liver cirrhosis was analyzed.Results There was a significant correlation between LSV and pathological grade of liver cirrhosis(r=0.693,P<0.05).The AUC of LSV for estimating mild,moderate and severe cirrhosis were 0.91,0.81 and 0.80,respectively.Conclusion There was a significant positive correlation between LSV and pathological grade of liver cirrhosis.LSV can be used as an effective parameter in evaluating the pathological severity of liver cirrhosis.

Key words: direct measurement, liver stiffness, liver stiffness grading, pathological grading of liver cirrhosis, Laennec classification

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