Application Of ARFI Technology And Total Bile Acid In Serum Analysis In The Child-Pugh Grading Of Chronic Hepatitis C Cirrhosis

AIM:To explore the characteristics of quantitative parameters of the shear wave velocity of ARFI and laboratory serum total bile acid in patients with chronic hepatitis C cirrhosis, and their relations with Child – Pugh scoring. To evaluate the relevant basis of liver reserve function was provided by using Liver SWV value and the serum total bile acid levels, practically.METHODS: To measure the liver shear wave velocity of 86 patients with clinically diagnosed chronic hepatitis c cirrhosis and 30 healthy volunteers by using acoustic pulse radiation elasticity imaging techniques. To repeated measurements of each object of study 10 times. Effective data standards for success rate(SR) > 60%, and the interquartile ratio of the measured value of the median(IQR/M) < 30%. Calculate the average was included in the statistics. The same day,venous blood was collected on an empty stomach to test serum total bile acid. According to the biochemical indexes and clinical manifestations, 86 patients with clinically diagnosed chronic hepatitis c cirrhosis were undertaken Child-Pugh scoring. The normal distribution test was conducted in the livers SWV. The f test was conducted in the serum total bile acid. Liver shear wave velocity(SWV) and total bile acid(TBA) in serum relations with Child – Pugh scoring were measured analyzed. By drawing a scatter diagram and doing statistical correlation to analysis the liver SWV value correlation between the serum total bile acid. The cut-off value and the area under the receiver operating characteristic curve(AUROC) of the liver SWV and the serum total bile acid in Child-Pugh scoring were determined with receiver operating characteristic curve(ROC).RESULTS: For 86 patients with mean age of 56 Y±11.2 Y, of which 40 males and 46 females, the mean SWV value were 2.44 m/s±0.39 m/s and mean TBA were 27.2μmol/L±29.7μmol/L. There is no statistical significance of gender and age among patients graded with Child-Pugh A, B and C.For 30 healthy volunteers, the mean value of liver SWV were 1.07m/s±0.09m/s and the mean value of TBA in serum were 4.46μmol/L±2.02μmol/L. The liver SWV and TBA in serum values were significantly higher in the experiment group than in the control group(P<0.05). The mean value of liver SWV and TBA in patients graded with Child-Pugh A, B and C were 2.34 m/s±0.33m/s and 14.6μmol/L±13.8μmol/L; 2.39 m/s±0.39 m/s and 35.6μmol/L±36.5μmol/L; 2.76m/s±0.34 m/s and 38.9μmol/L±31.8μmol/L, respectively. The difference of the value between different Child-Pugh grading patients is of statistical significance(P<0.05). The values of liver SWV were analyzed by using test of variance between groups, the result showed that the Child-Pugh C liver SWV value with A and B grade had statistical significance(P = 0.001, P <0.05), between the liver SWV value of Child-Pugh A and Child-Pugh B has no statistical significance, the medical reference range are: 2.24 ~2.46 m/s, 2.25 ~ 2.53 m/s, 2.57 ~ 2.94 m/s.The values of TBA in serum were analyzed by using Kruskal Wallis test, the results showed that the TBA in serum of the value between different Child-Pugh grading patients is of statistical significance(P = 0.000, P < 0.05), the medical reference range are: 9.99-19.20μmol/L、22.71-48.58μmol/L、21.89-55.84μmol/L。According to the ROC curve is shown in SWV and TBA area under the curve is 0.791 and 0.684, respectively( a P =0.000, a P <0.05; c P=0.022, c P <0.05), the boundary value points are: 2.49, 23.85.The liver SWV and TBA have good correlation with Child– Pugh grading, and an increasing tendency from Child-Pugh grading A to C. The liver SWV and TBA have higher sensitivity in the diagnosis of liver cirrhosis, the area under the curve of ROC for SWV is larger.CONCLUSION:SWV of the liver and TBA in the serum have good correlation with hepatic Child-Pugh grading.Therefore SWV and TBA can serve as an effective supplement for Child-Pugh grading, to better evaluate the liver reserve functional.