| Purpose:This study by detecting chronic HBV infected serum liver fibrosis indexes and Real time shear wave elastography (SWE) measured Hepatic elastic modulus, discuss both correlation, and the correlation with liver tissue pathology.Methods:Selection of liver disease in the Second People’s Hospital of YunNan outpatient service (July2012to April2013) of78cases of chronic HBV patients as the research object. According to people’s medical publishing house published "Epidemiology" seventh edition teaching material, the object of study can be divided into:chronic hepatitis b carriers group, mild group and moderate/severe chronic hepatitis b, hepatitis b, liver cirrhosis and primary hepatocellular carcinoma (HCC), infection recovery group; According to the HbeAg research object will be divided into the HbeAg negative group and positive group; According to the liver tissue pathology group. Among them,78cases of patients were the serum liver fibrosis indexes detection and SWE,30cases of liver tissue biopsy, blood biochemical index detection using automatic biochemistry analyzer, HBV markers by time-resolved fluorescence immunoassay (TRFIA), HBV-DNA levels by fluorescence quantitative polymerase chain reaction (FQ-PCR) methods. By using proper disposing and analyzing data use SPSS19statistical package. Correlation analysis use Spearman Rank Test line.Results:1. Collected a total of78cases of samples (including30patients with hepatic biopsy), carriers of31cases;28patients with mild chronic hepatitis b;5patients with moderate/severe chronic hepatitis b; Hepatitis b cirrhosis of the liver/HCC10patients; Infection4cases of convalescence patients. Subjects’average age was35.6±13.8years old, male patients with60cases,18cases of female patients; Fixed professional freelance24cases of patients, including workers, students, etc.54cases; The han nationality patients71cases,7patients with ethnic minorities;14patients with antiviral treatment, has received32patients with antiviral treatment has now stopped,32patients with untreated; With25patients with a clear family history, deny that53patients with family history.2. The correlation of serum liver fibrosis indexes and Hepatic elastic modulus analysis2.1. Different clinical diagnosis in patients with serum liver fibrosis indexes and Hepatic elastic modulus analysis of the correlationIn78cases of patients, serum liver fibrosis indexes in the detection and Hepatic elastic modulus measurement. At the carriers in the group:HA, PIIINP, LN and IVC respectively with SWE do correlation analysis, HA and the elastic modulus of S6were positively correlated (correlation coefficient r=0.44, P<0.05), and S5, no correlation (P>0.05); LN and S5/S6elastic modulus into positive correlation (correlation coefficient r=0.49, p<0.01),(the correlation coefficient r=0.67, p<0.01); IVC and S6elastic modulus into positive correlation (correlation coefficient r=0.51, p<0.01), and S5, no correlation (p>0.05); PⅢNP and S5and S6, no correlation (P>0.05); In CHB mild group and moderate/severe chronic hepatitis b, liver cirrhosis/HCC, and infection in recovery group, HA, PⅢNP, LN and IVC respectively with SWE do correlation analysis, there were no correlation (P>0.05).2.2. The HbeAg negative group and positive group of serum liver fibrosis indexes and Hepatic elastic modulus in patients with correlation analysisIn78patients serum liver fibrosis indexes detection and Hepatic elastic modulus measurement,46cases of patients is HbeAg (-),32cases of patients is HbeAg (+). In32cases of HbeAg (+) patient group, HA, PIIINP, LN and IVC respectively with SWE do correlation analysis, HA and the elastic modulus of S6were positively correlated (correlation coefficient r=0.59, P<0.01), and S5, no correlation (P>0.05); LN and the elastic modulus of S5and S6were positively related (correlation coefficient r=0.37, p=0.04),(the correlation coefficient r=0.43, p=0.01); IVC and the elasticity of S6were positively correlated (correlation coefficient r=0.40, p=0.02), and S5, no correlation (p>0.05); PⅢNP and S5/S6, no correlation (P>0.05); In46cases of HbeAg (-) in the patient group, HA, PIIINP, LN and IVC respectively with SWE do correlation analysis, HA and the elastic modulus of S5and S6were positively correlated (correlation coefficient r=0.70, P<0.01),(the correlation coefficient r=0.67, P <0.01); PIIINP and S5/S6elastic modulus were positively correlated (correlation coefficient r=0.65, P<0.01).2.3. Serum liver fibrosis indexes and Hepatic elastic modulus in patients with inflammation and liver tissue pathologic classification and correlation analysis of fibrosis stageIn78cases of patients,30cases of patients with serological detection of liver fibrosis and Hepatic elastic modulus measurement and liver biopsy. HA, PIIINP, LN, IVC, S5elasticity and S6elasticity and liver inflammation respectively classification of correlation analysis:Spearman rank correlation coefficient (r=1.00), P<1.00, P=0.02(r=0.75),(r=0.42), P<0.01),(r=0.37), P<0.01, P<(r=0.47) and0.01(r=0.51)(P<0.01; HA, PIIINP, LN, IVC, S5elasticity and S6of elastic modulus associated with liver fibrosis staging respectively analysis: Spearman rank correlation coefficient (r=1.00), P<1.00, P=0.02(r=0.72),(r=0.42), P<0.01, P<(r=0.37)0.01,(r=0.47), P<0.01and P<0.01.(r=0.51).2.4. Different liver tissue inflammation pathological grading, fibrosis staging serum liver fibrosis indexes and Hepatic elastic modulus in patients with correlation analysis2.4.1. Different inflammation grading serum liver fibrosis indexes and Hepatic elastic modulus correlation analysis. In30routine serological detection of liver fibrosis and Hepatic elastic modulus measurement and liver biopsy in patients, different inflammation grading serum liver fibrosis indexes and Hepatic elastic modulus correlation analysis:in G0/G1group, HA, PⅢNP, LN, IVC and elastic modulus of the S5and S6no relationship; G2group, HA and the elastic modulus of S6were positively correlated (correlation coefficient r=0.62, p<0.05), S5, no correlation (p>0.05); PIIINP and S5/S6elastic modulus were positively correlated (correlation coefficient r=0.60, P<0.05),(the correlation coefficient r=0.56, P<0.05); IVC and the elasticity of S5and S6were positively related (correlation coefficient r=0.64, p<0.01),(the correlation coefficient r=0.53, p<0.05); G3/G4group, LN and the elastic modulus of S5were positively correlated (correlation coefficient r=0.89, p<0.05), and S6, no correlation (p>0.05); IVC and the elastic modulus of S5were positively correlated (correlation coefficient r=0.88, p<0.05), and S6, no correlation (p>0.05).2.4.2. Different fibrosis staging serum liver fibrosis indexes and Hepatic elastic modulus correlation analysisIn30cases of serological detection of liver fibrosis and Hepatic elastic modulus measurement in patients with liver biopsy, different staging of fibrosis serum liver fibrosis indexes and Hepatic elastic modulus correlation analysis:S0/S1group, HA, PⅢNP, LN, IVC and elasticity of S5and S6no relationship; S2group, HA and the elastic modulus of S6were positively correlated (correlation coefficient r=0.57, p<0.05), S5, no correlation (p>0.05); PⅢNP and S5and S6elastic modulus were positively correlated (correlation coefficient r=0.60, P <0.05),(the correlation coefficient r=0.64, P<0.05); IVC and the elasticity of S5and S6were positively related (correlation coefficient r=0.69, p<0.01),(the correlation coefficient r=0.56, p<0.05); The S3/S4group, HA, PIIINP, LN, IVC and elastic modulus of the S5and S6has no relationship.3. The serum liver fibrosis indexes in patients with different clinical diagnosis3.1Different clinical diagnosis of patients with serum levels of HA78cases of patients with chronic HBV infection and20cases of healthy control subjects were serum liver fibrosis indexes detection. HA in the clinical diagnosis group and health control group difference is compared between (P=0.00). Further compared between two groups, there are difference between CHB mild and hepatitis b cirrhosis of the liver/HCC group, CHB mild group and the control group, liver cirrhosis/HCC group and carriers of hepatitis b, carrier group and the control group, the infected recovery group and the control group (P<0.05). Others are no differences between groups (P>0.05).3.2Different clinical diagnosis of patients with serum PIIINPPIIINP in various clinical diagnosis group and health control group difference is compared between (P=0.00). Further compared between two groups, the differences between clinical diagnosis groups, respectively, compared with healthy control group (P<0.05). Others are no differences between groups (P>0.05).3.3Serum LN in patients with different clinical diagnosisLN comparison between various clinical diagnosis group and healthy control group differences (P=0.00). Further compared between two groups, the clinical diagnosis groups, respectively, compared with healthy control group, chronic hepatitis b, mild group and hepatitis b liver cirrhosis/HCC, liver cirrhosis/HCC group and carriers of hepatitis b, comparing differences (P<0.05). Others are no differences between groups (P>0.05).3.4Different clinical diagnosis of patients with serum comparing IVC There are no differences between groups (P>0.05).4. The different levels of serum liver fibrosis indexes of elastic modulus value Different levels of serum liver fibrosis indexes (HA, PⅢNP, LN, IVC) S5and S6stage liver elastic modulus value have differences (P=0.00).Conclusions1. Serum liver fiber four and liver tissue inflammation pathological grading and staging of fibrosis has good correlation, serum liver fiber four can serve as an indicator of auxiliary diagnosis of liver fibrosis.2. The four serum liver fiber and SWE in evaluating the extent of fibrosis in chronic HBV infection has a better consistency, both can be jointly applied in the assessment of chronic HBV infection of liver fibrosis, a noninvasive, quick, simple and repeatable characteristics. |
PDF Full Text Request