目的 探索肝脏剪切波速度( shear wave velocity,SWV)评估肝豆状核变性患者发生脾亢的可行性。方法 选取2018-10至2020-07于安徽中医药大学第一附属医院接受超声检查的42例肝豆状核变性( hepatolenticular degeneration, HLD)患者,利用声脉冲辐射力成像技术测量肝脏SWV值,按照是否合并脾功能亢进将42例HLD患者分为两组,比较两组间SWV值及血常规指标(WBC、RBC、PLT)是否存在统计学差异。将SWV值与WBC、RBC、PLT进行相关性分析,并绘制ROC曲线检验肝脏SWV值诊断效能。结果 42例中,A 组(HLD不合并脾亢)32例,B 组(HLD合并脾亢)10例。单因素分析:两组的SWV值、WBC、RBC、PLT差异均具有统计学意义(P<0.05);相关性分析:肝脏SWV值与WBC、RBC、PLT均具有相关性,其中SWV值与WBC、PLT呈显著负相关(r=-0.579、-0.548,P=0.000、0.000),与 RBC呈弱负相关(r=-0.310,P=0.046);绘制肝脏SWV值评估脾亢的ROC曲线,曲线下面积:0.850,95% CI:0.702~0.998,最佳截断值为2.0,敏感度(Se)及特异度( Sp)分别为90%、84.4%。结论 利用ARFI技术测量肝豆状核变性患者肝脏SWV值对评估脾亢具有较高的敏感度和特异度。
Abstract
Objective To explore the feasibility of patients with hepatolenticular degeneration complicated with hypersplenism being evaluated by the liver shear wave velocity (SWV).Methods Forty-two patients with hepatolenticular degeneration (HLD) who had received ultrasonography examination between October 2018 and July 2020 were selected. The liver SWV was measured by means of the acoustic radiation force impulse.According to the occurrence of hypersplenism, these patients were divided into two groups. The SWV and blood routine indexes (WBC, RBC and PLT) were compared between the two groups for statistical analysis. The correlations of the SWV with the white blood cell count (WBC), the red blood cell count (RBC) and the platelet count (PLT) were analyzed, and the ROC curve was plotted to determine the diagnostic efficiency of the liver SWV.Results Among the 42 patients, 32 did not develop hypersplenism (group A) and 10 were complicated with hypersplenism (group B). According to univariate analysis, the difference in values of SWV, WBC, RBC and PLT between the two groups was statistically significant (P< 0.05). The liver SWV was correlated with WBC, RBC and PLT, but was significantly negatively correlated with WBC and PLT (r=-0.579,-0.548,P=0.000, 0.000), and weakly with RBC(r=-0.310, P=0.046).The area under the curve was 0.850,95%CI: 0.702-0.998,and the best truncation value was 2.0. The sensitivity (Se) and specificity (Sp) were 90% and 84.4% respectively.Conclusions ARFI technology has a high sensitivity and specificity to hypersplenism when used to measure the liver SWV of HLD patients.
关键词
剪切波速度 /
肝豆状核变性 /
脾功能亢进 /
超声
Key words
shear wave velocity /
hepatolenticular degeneration /
hypersplenism /
ultrasonography
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基金
安徽省2018年度重点研究与开放计划(1804h08020243)
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