摘要
目的：探讨慢性乙型肝炎患者肝脏31P MRS波谱及代谢生化信息特点，以及与肝功能变化之间的相关性及临床价值。方法：按2000年西安会议全国病毒性肝炎防治方案标准，将26例慢性乙型肝炎患者分为轻、中、重及肝功能正常肝炎组，并选择20例健康志愿者作对照，分别行常规MR扫描及31P MRS成像，观察31P MRS波谱及代谢生化信息特点，并分析各指标与肝功能生化指标（ATL、AST）之间的相关性。结果：对照组的%PME及PME/PDE分别为9.32±2.74，0.31±0.06，肝功能正常肝炎组分别为9.5±4.2，0.32±0.14，轻度组分别为10.97±1，0.38±0.08，中度组分别为12.59±3.18，0.45±0.13，重度组分别为15.49±4.7，0.53±0.14。肝功能正常的肝炎患者各31P MRS指标与对照组无统计学差异，而对照组与重度组、轻度组与重度组之间的 %PME，以及对照组与中度组、对照组与重度组、轻度组与重度组之间的PME/PDE有统计学差异，其中PME/PDE与ALT呈正相关（P=0.037），而与AST无相关性（P=0.075）。结论：肝脏31P MRS能无创的、直接的检测肝代谢过程的生化信息及能量状况，能提示慢性乙型肝炎患者有肝功能损害程度，对慢性乙型肝炎患者的肝功能检测及监测具有重要价值。
Abstract
Objective: To study the feature of spectroscopy and metabolism in chronic hepatitis B by in vivo 31P MR spectroscopy, and investigate its relationship to the serum transaminase. Methods: Twenty healthy controls and 26 patients with etiologic-proven HBV-related liver were studied. Base on the status of hepatic function, patients were divided into mild, moderate, severe and normal liver function hepatitis. Hepatic MR scanning and 31P MR spectra were obtained using 1.5T spectroscopy system. To investigate the feature of the spectrum and metabolism in chronic hepatitis B, and the relationship to the serum transaminase. Results: The %PME and PME/PDE of control group are 9.32±2.74 and 0.31±0.06, the value in normal liver function hepatitis are 9.5±4.2 and 0.32±0.14, in mild group are 10.97±1 and 0.38±0.08, in moderate group are 12.59±3.18 and 0.45±0.13, in severe group are 15.49±4.7 and 0.53±0.14. There were insignificant differences between control group and hepatitis with normal liver function. There were significant differences between control group and severe, mild and severe in %PME. A monotonic increase in PME/PDE ratio with increasing severity of disease was statistically significant differences between the control and moderate, control and severe, mild and severe. The PME/PDE ratio correlated with the alanine aminotransferase(ALT), but not correlated with aspartate aminotransferase(AST). Conclusion: We can detect the status of hepatic metabolism and energy by 31P MRS noninvasively and directly, and is valuable to investigate the status of hepatic function in chronic hepatitis B.
关键词
肝炎 /
乙型 /
慢性 /
血清流行病学研究 /
磁共振波谱学
Key words
hepatitis B /
chronic /
seroepidemiologic studies /
magnetic resonance spectroscopy
崔恩铭;谭理连;李志铭;汪银玉;林 凡;刘 克;黄 勇.
慢性乙型肝炎患者31P MRS与血清肝功能相关性研究[J]. 中国临床医学影像杂志. 2007, 18(11): 789-792
CUI En-ming;TAN Li-lian;LI Zhi-ming;WANG Yin-yu;LIN Fan;LIU Ke;HUANG Yong.
Relationship of in vivo 31P MR spectroscopy to serum transaminase in chronic hepatitis B[J]. Journal of China Clinic Medical Imaging. 2007, 18(11): 789-792
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