摘要
目的探究慢性乙型肝炎(CHB)患者肝纤维标志物与中医证型及多层螺旋CT(MSCT)灌注成像参数的关系。方法以2016年1月—2021年1月90例CHB患者为研究对象,根据肝纤维化程度的不同将患者分为S0组、S1~S2组及S3~S4组。比较不同纤维化程度患者肝纤维标志物水平及MSCT灌注成像参数,分析其对肝纤维化程度的评估价值及MSCT灌注成像参数与肝纤维化标志物的相关性,并分析中医证型与肝纤维标志物水平的关系。结果透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(CⅣ)水平随着肝纤维化分级的升高而升高(P<0.05);HA、PCⅢ、CⅣ水平联合检测评估CHB患者肝脏纤维化的曲线下面积(AUC)大于各指标单独检测(P<0.05);瘀血阻络证患者HA、PCⅢ、CⅣ水平高于其他证型,肝郁脾虚证患者HA、PCⅢ、CⅣ水平低于其他证型(P<0.05);肝动脉灌注量(HAP)、灌注指数(HPI)值随着肝脏纤维化分级的升高而增大,门静脉灌注量(PVP)、总肝灌注量(THBF)值随着肝脏纤维化分级的升高而而减少(P<0.05);HA、PCⅢ、CⅣ水平与PVP值呈正相关,与THBF值呈负相关(P<0.05)。结论不同中医证型CHB患者肝纤维标志物水平存在差异,且患者肝纤维标志物对肝脏纤维化程度具有评估价值,并与MSCT灌注成像参数具相关性。
Objective To explore the relationship between liver fiber markers and TCM syndromes,multi-slice spiral CT(MSCT)perfusion imaging parameters in patients with chronic hepatitis B(CHB).Methods A total of 90 patients with CHB were enrolled as the research objects between January 2016 and January 2021.According to the degree of liver fibrosis,they were divided into S0 group,S1-S2 group and S3-S4 group,levels of liver fiber markers and MSCT perfusion imaging parameters in different groups were compared.The evaluation value for the severity of liver fibrosis,the correlation between MSCT perfusion imaging parameters and liver fibrosis markers,and the relationship between TCM syndromes and liver fibers markers were analyzed.Results With the increase of liver fibrosis grading,levels of hyaluronic acid(HA),procollagen type III(PCIII)and collagen type IV(CIV)were increased(P<0.05).AUC of HA combined with PCIII and CIV for assessing liver fibrosis was greater than that of single index(P<0.05).The levels of HA,PCIII and CIV in patients with blood stasis obstructing collaterals were higher than those with the other syndromes,which were lower in patients with liver-stagnation spleen deficiency(P<0.05).With the increase of liver fibrosis grading,hepatic arterial perfusion(HAP)and hepatic perfusion index(HPI)were increased,while portal vein perfusion(PVP)and total hepatic blood flow(THBF)were decreased(P<0.05).The levels of HA,PCIII and CIV were positively correlated with PVP,while negatively correlated with THBF(P<0.05).Conclusion There are differences in levels of liver fiber markers in patients with CHB of different TCM syndromes.The liver fiber markers are of evaluation value for the severity of liver fibrosis,which are correlated with MSCT perfusion imaging parameters.
作者
朱峰
张荣坤
刘桂林
ZHU Feng;ZHANG Rongkun;LIU Guilin(Jiande First People's Hospital,Jiande 311600,Zhejiang,China)
出处
《辽宁中医杂志》
CAS
2022年第9期134-137,223,共5页
Liaoning Journal of Traditional Chinese Medicine
基金
浙江省中医药科技计划项目(2014ZA089,2015ZA167)
