摘要
目的：应用实时剪切波弹性成像技术测定慢性乙型病毒肝炎患者肝脏杨氏模量值，评价替比夫定对慢性乙型病毒肝炎肝纤维化治疗效果。方法：选择慢性乙型病毒肝炎肝纤维化患者80名（均在治疗前进行肝活检），A组（S0，S1）22例，B组（S2，S3）40例，C组（S4）18例，所有患者进行替比夫定药物治疗，分别在治疗前和治疗后24周进行实时剪切波弹性成像测量肝脏杨氏模量值和血清学检查，包括透明质酸（Hyaluronic acid，HA）、层黏蛋白（LN）、三型前胶原N端肽（PⅢPN-P）、Ⅳ型胶原（CL-Ⅳ），比较各参数治疗前后变化。结果：所有A、B、C 3组血清学指标HA、LN、PⅢPN-P、CL-Ⅳ治疗24周后均较治疗前降低，差异均有统计学意义（P＜0.05），而所有A、B、C 3组实时剪切波弹性测量肝脏杨氏模量值治疗后均比治疗前降低，差异均有统计学意义（P＜0.05）。治疗前与治疗后实时剪切波弹性测量肝脏杨氏模量值均为A组＜B组＜C组。结论：实时剪切波弹性成像测量肝脏弹性模量值可以用来对替比夫定治疗慢性乙型肝炎疗效进行评估。
Abstract
Objective: To assess the effect of telbivudin anti-fibrosis treatment in chronic hepatitis B by using the liver Young’s modulus of patients with chronic hepatitis B tested by real-time shear wave elastography. Methods: Eighty chronic hepatitis B patients with liver fibration(liver biopsies were performed before treatment) were enrolled and divided into 3 groups, group A(S0, S1) which contains 22 patients, group B(S2, S3) which contains 40 patients, and group C(S4) which contains 18 patients. All the patients were under the treatment of telbivudin, and respectively tested the liver Young’s modulus before treatment and 24 weeks after treatment by using real-time shear wave elastography, and the serum test including hyaluronic acid(HA), laminin(LN), type Ⅳ collagen(CL-Ⅳ), serum type Ⅲ procollagen(PⅢPN-P) were measured in all patients. Result: All serum index(HA, LN, CL-Ⅳ and PⅢPN-P) in three groups decrease 24 weeks after treatment vs before, the difference is statistically significant(P＜0.05), and Young’s modulus of liver tested by real-time shear wave elastography also decrease 24 weeks after treatment vs before, the difference is statistically significant(P＜0.05), Young’s modulus of liver in three groups were group A＜group B＜group C 24 weeks after treatment and before. Conclusion: Real-time shear wave elastography testing liver flexible modulus could be used in assessing the effect of telbivudin treatment in chronic hepatitis B.
关键词
肝炎 /
乙型 /
肝硬化 /
超声检查 /
多普勒 /
彩色
Key words
Hepatitis B /
Liver cirrhosis /
Ultrasonography /
Doppler /
color
史红梅;王倩晖;高 莉.
病毒肝炎肝纤维化的治疗效果初步研究[J]. 中国临床医学影像杂志. 2015, 26(6): 405-407
SHI Hong-mei;WANG Qian-hui;GAO Li.
The pilot research of assessing the efficacy of telbivudin anti-fibrosis treatment in chronic hepatitis B by real-time shear wave elastography[J]. Journal of China Clinic Medical Imaging. 2015, 26(6): 405-407
中图分类号：
Ｒ512.62
Ｒ575.2
Ｒ445.1
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