| Background: the treatment and prognosis of patients with various chronic liver diseases are closely related to the degree of liver fibrosis,which is induced by abnormal hyperplasia of connective tissue in the liver,further affects the structure and function of the liver.The most important of these factors is the persistent chronic inflammation of the liver and the activation of hepatic stellate cells in the liver.These cells cause structural changes in the original liver,destroy the normal Hemodynamics both inside and outside the liver,and cause abnormal liver function,which leads to further progression of liver fibrosis towards decompensation,cirrhosis and liver cancer.Therefore,timely and accurate diagnosis of liver fibrosis,and effective intervention strategy for patients with their own long-term liver fibrosis with the first block,then reverse the clinical significance.Liver biopsy has been used to diagnose and evaluate the degree of liver fibrosis.And yet,.Liver biopsies also have many shortcomings,such as not providing information on whether the disease is progressing,regressing,or resting.However,many shortcomings of liver biopsy technology have indirectly resulted in a large class of clinical non-invasive features,but also with a more accurate diagnosis of liver fibrosis degree of new ways.Elastography provides a reliable,timely and dynamic new method for clinical diagnosis and monitoring of liver fibrosis.The purpose of this study is to diagnose the degree of advanced hepatic fibrosis in HBe Ag-negative Hepatitis B patients by using transient elastography and serum markers.Objective: to reduce the necessity of liver biopsy and the risk of liver biopsy in patients with advanced liver fibrosis,it provides a reliable,timely and dynamic non-invasive method for clinical diagnosis,monitoring and evaluation of advanced hepatic fibrosis.Methods: from January 2017 to October 2019,a total of 108 patients with HBe Ag-negative chronic hepatitis B were investigated.Inclusion criteria: 1.In this study,the subjects of HBe Ag-negative chronic hepatitis B were required to meet the diagnostic criteria in “Guidelines for the prevention and treatment of chronic hepatitis B(2019 edition)”.2.Chronic Hepatitis B course > 1 year.The subjects were divided into progressive fibrosis group(≥ s 2 stage)and non-significant fibrosis group(< s 2 stage)according to histological stages.Prior to the experiment,the medical ethics committee of our hospital approved the modification of consent,all participants are willing to participate in the experiment,and study with the subject I signed informed consent.Methods: 1.Routine two-dimensional ultrasound examination: to obtain two-dimensional ultrasound images of the patient’s abdomen,choose the appropriate elastic detection position.2.Transient elastography: the UK acoustic Fibro Touch transient elastography facility.The elastic imaging function was triggered after the parameters were set,and the elastic values of the region of interest of the liver were measured.3,the Laboratory Inspection Index: the inspection method according to the respective reagent inspection box instruction manual carries on the operation.4.Pathological examination: liver biopsy requires a large needle puncture,specimen length should be more than 1.0 cm.The degree of liver fibrosis in each patient was assessed by the MERAVIR scoring system of the consensus for the diagnosis and treatment of liver fibrosis(2019).Statistical Processing: In this experiment,all the data of the subjects were used statistical software SPSS20.0,using statistical analysis and mapping.Kruskal-wallis single-factor analysis of variance was used for the comparison among different groups.The mean ± standard deviation was used to express each group’s continuous variables.The area under the maximum curve of liver hardness was evaluated by using the working characteristic curve of the subjects,and the best cut-off value was obtained according to the Yuden Index.Results: first,in this study,the Yang modulus LSM of the subjects increased with the histological grading of liver biopsy fibrosis.The Spearman correlation coefficient was0.71(p = 0.00)between liver hardness LSM and liver biopsy grade in advanced fibrosis group,but 0.64(p < 0.05)in non-significant fibrosis group.At the same time,in the experiment,multiple regression analysis was used to study the correlation factors of liver fibrosis in HBe Ag negative patients with LSM,HA,LN,IV-C,pcii,AST and ALT in advanced fibrosis group(≥ s 2 stage)and non-significant fibrosis group(< s 2 stage),l SM,HA,LN and IV-C were the influencing factors of the degree of liver fibrosis(p <0.05).Conclusion: LSM combined with HA and AST can identify patients with S2-S3 stage liver fibrosis,reduce the need for biopsy,and provide a dynamic and non-invasive assessment of liver fibrosis. |
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