摘要
目的 研究高频超声和低频超声诊断慢性乙肝早期肝硬化的临床应用价值。方法 选择甘肃省中医院超声医学影像科2021年6月至2024年3月收治的40例慢性乙肝早期肝硬化患者,以患者的病变结果为根据,分为代偿期肝硬化组(n=22)和失代偿期肝硬化组(n=18),然后选择在甘肃省中医院超声医学影像科同时期接受检查的慢性乙肝患者40例,将其作为对照组。所有患者均实施高频超声技术、低频超声技术和联合超声诊断,比较三组患者的超声半定量评分,包膜夹角、包膜夹角方差、连续性线段数量,脾静脉、门静脉内径及速度,比较三种方法对肝硬化的诊断结果及三种方法的诊断效能。结果 失代偿期肝硬化组患者的各项超声半定量评分高于代偿期肝硬化组及对照组,差异有统计学意义(P <0.05)。失代偿期肝硬化组患者的包膜夹角均值、包膜夹角方差、连续性线段数量高于代偿期肝硬化组及对照组,差异有统计学意义(P <0.05)。失代偿期肝硬化组患者的脾静脉、门静脉内径高于代偿期肝硬化组及对照组,对照组脾静脉、门静脉血流速度高于代偿期肝硬化组及失代偿期肝硬化组,差异有统计学意义(P <0.05)。低频联合高频超声诊断灵敏度、特异度、阳性预测值、阴性预测值均高于高频超声及低频超声,低频超声与低频联合高频超声检查的灵敏度比较,差异有统计学意义(P <0.05),其余指标比较,差异无统计学意义(P> 0.05)。结论 慢性乙肝早期肝硬化患者通过低频联合高频超声进行诊断,可将患者的肝包膜、肝实质细微性变化进行清晰展示,诊断效能以及临床应用价值较高,值得推广。
Objective To study the clinical application value of high-frequency ultrasound and low-frequency ultrasound in the diagnosis of early cirrhosis of chronic hepatitis B.Methods A total of 40 patients with early cirrhosis of chronic hepatitis B who were admitted to the Ultrasound Medical Imaging Department of Gansu Provincial Hospital of Traditional Chinese Medicine from June 2021 to March 2024 selected.Based on the pathological results of the patients,they were divided into compensated cirrhosis group(n=22)and decompensated cirrhosis group(n=18).Then 40 patients with chronic hepatitis B who were examined in the Ultrasonic Medical Imaging Department of Gansu Provincial Hospital of Traditional Chinese Medicine at the same time were selected as the control group.All patients were diagnosed with high-frequency ultrasound,low-frequency ultrasound and combined ultrasound.The ultrasonic semi-quantitative score,capsule angle,variance of capsule angle,number of continuous line segments,internal diameter and velocity of splenic vein and internal diameter and velocity of portal vein were compared among the three groups.The diagnostic results of three methods for liver cirrhosis and diagnostic efficiency of three methods were compared.Results The ultrasonic semi-quantitative scores of patients in the decompensated cirrhosis group were higher than those in the compensated cirrhosis group and the control group,and the differences were statistically significant(P<0.05).The mean capsule angle,variance of capsule angle,and number of continuous line segments in the decompensated cirrhosis group were higher than those in the compensated cirrhosis group and the control group,and the differences were statistically significant(P<0.05).The splenic vein diameter and portal vein diameter of patients in the decompensated cirrhosis group were higher than those in the compensated cirrhosis group and the control group.The portal vein blood flow velocity and splenic vein blood flow velocity in the control group were higher than those in the compensated cirrhosis group and the decompensated cirrhosis group, and the differences were statistically significant (P < 0.05). The sensitivity, specificity, positive predictive value, and negative predictive value of low-frequency combined with high-frequency ultrasound diagnosis are all higher than those of high-frequency ultrasound, and higher than those of low-frequency ultrasound. The sensitivity of low-frequency ultrasound was compared with that of low-frequency ultrasound and high-frequency ultrasound, with significant difference (P < 0.05), and the other indexes were compared among groups without significant difference (P > 0.05). Conclusion High-frequency ultrasound combined with low-frequency ultrasound can clearly show the subtle changes of liver capsule and liver parenchyma in patients with early cirrhosis of chronic hepatitis B, which has high diagnostic efficiency and clinical application value and is worth popularizing.
作者
徐丽娜
XU Lina(Gansu Provincial Hospital of Traditional Chinese Medicine,Gansu,Lanzhou 730050,China)
出处
《中国医药科学》
2025年第3期172-176,共5页
China Medicine And Pharmacy
关键词
高频超声
低频超声
慢性乙肝
肝硬化
诊断效能
High-frequency ultrasound
Low-frequency ultrasound
Chronic hepatitis B
Cirrhosis
Diagnostic efficiency
