剪切波弹性成像在抑郁症合并肝功能异常患者肝纤维化评估中的应用OA
Application of shear wave elastography in evaluating liver fibrosis in patients with depression and abnormal liver function
目的:探讨剪切波弹性成像(SWE)在抑郁症合并肝功能异常患者肝纤维化评价中的应用.方法:选取抑郁症合并肝功能异常患者70例(肝功能异常组)、抑郁症肝功能正常患者70例(肝功能正常组)及同期健康体检者70例(对照组)作为研究对象.3组均行SWE、血常规、肝功能[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)、总胆红素、间接胆红素、白蛋白等]、肝纤维化血清学[Ⅲ型前胶原肽(PC Ⅲ)、Ⅳ型胶原(C-Ⅳ)、透明质酸、层粘连蛋白]检查,计算肝纤维化指数4(FIB-4)、ALT与血小板比值(APRI)和Forns指数.分析肝功能异常组治疗前后及其与其他2组各指标的差异,以及各指标间的相关性.结果:与对照组相比,肝功能异常组治疗前的总胆红素、直接胆红素、间接胆红素、ALT、AST、GGT均升高(均P<0.05);治疗后总胆红素、间接胆红素、总胆固醇、甘油三酯、BMI均升高(均P<0.05).与治疗前相比,肝功能异常组治疗后的总胆红素、直接胆红素、间接胆红素、ALT、AST、GGT明显降低(均P<0.05),甘油三酯、总胆固醇、BMI明显升高(均P<0.05).肝功能异常组治疗前FIB-4、APRI、Forns指数、PC Ⅲ、层粘连蛋白、C-Ⅳ、透明质酸、杨氏模量值均高于对照组(均P<0.05);治疗后层粘连蛋白、杨氏模量值均高于对照组(均P<0.05);与治疗前相比,肝功能异常组治疗后FIB-4、APRI、Forns指数、PC Ⅲ、层粘连蛋白、C-Ⅳ、透明质酸、杨氏模量值均降低(均P<0.05).医师内ICC为0.933(95％CI 0.831～0.976);医师间ICC为0.901(95％CI 0.798～0.931).Pearson相关性分析表明,杨氏模量值与层粘连蛋白、ALT、AST呈极强相关;与透明质酸、C-Ⅳ、PC Ⅲ、AST、BMI呈强相关;与甘油三酯、总胆固醇呈弱相关(均P<0.01).结论:SWE的杨氏模量值可定量评估抑郁症合并肝功能异常患者的肝纤维化状况,有较好的临床应用前景.
Objective:To investigate the application of shear wave elastography(SWE)in evaluating liver fibrosis in patients with depression and abnormal liver function.Methods:A total of 70 patients with depression and abnormal liver function(dysfunction group),70 patients without abnormal liver function(normal-function group)and 70 healthy subjects(control group)were selected.Three groups underwent SWE,blood routine,liver function(ALT,AST,GGT,total bilirubin,indirect bilirubin,albumin,etc.)and serum liver fibrosis(PC Ⅲ,C-Ⅳ,hyaluronic acid,laminin)examinations,and the corresponding liver fibrosis indicators(APRI,FIB-4,Forns index)were calculated.The differences and correlations of all indicators of each group and between pre-treatment and post-treatment in the dysfunction group were statistically analyzed.Results:Compared with the control group,the levels of total bilirubin,direct bilirubin,indirect bilirubin,ALT,AST and GGT before treatment in the dysfunction group were all increased(all P<0.05),and the levels of total bilirubin,indirect bilirubin,total cholesterol,triglycerides and BMI after treatment were increased(all P<0.05).In the dysfunction group,compared with pre-treatment,the levels of the total bilirubin,direct bilirubin,indirect bilirubin,ALT,AST,GGT after treatment were significantly decreased(all P<0.05),while the levels of total cholesterol,triglycerides and BMI were significantly increased(all P<0.05).Compared with the control group,the levels of FIB-4,APRI,Forns index,PC Ⅲ,laminin,C-Ⅳ,hyaluronic acid and Young's modulus before treatment in the dysfunction group were statistically higher,and the laminin level and Young's modulus after treatment were statistically higher(both P<0.05).In the dysfunction group,compared with pre-treatment,the levels of FIB-4,APRI,Forns index,PC Ⅲ,laminin,C-Ⅳ,hyaluronic acid,and Young's modulus were decreased after treatment(all P<0.05).Intra-physician ICC was 0.933(95％CI 0.831-0.976),and inter-physician ICC was 0.901(95％CI 0.798-0.931).Pearson correlation analysis showed that Young's modulus had a very strong correlation with laminin,ALT and AST,a strong correlation with hyaluronic acid,C-Ⅳ,PC Ⅲ,AST and BMI,and a weak correlation with total cholesterol and triglycerides(all P<0.01).Conclusion:The Young's modulus of SWE technology can quantitatively evaluate the liver fibrosis in patients with depression and abnormal liver function.
刘娟;韦朝阳;何江涛;陈万明;孙红光
南京医科大学康达学院附属连云港第四人民医院超声科,江苏 连云港 222023南京医科大学康达学院附属连云港第四人民医院超声科,江苏 连云港 222023南京医科大学康达学院附属连云港第四人民医院放射科,江苏 连云港 222023南京医科大学康达学院附属连云港第四人民医院精神科,江苏 连云港 222023南京医科大学附属明基医院超声科,江苏 南京 210026
医药卫生
超声检查弹性成像技术肝纤维化抑郁症肝纤维化血清学指标
UltrasonographyElasticity imaging techniquesLiver fibrosisDepressionSerum markers of liver fibrosis
《中国中西医结合影像学杂志》 2026 (1)
80-85,6
连云港市卫生科技项目(ZD202307)南京医科大学康达学院2023年度科研发展基金(KD2023KYJJ131).
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