The Value Of Ultrasound Imaging Index And Serological Index Combined Model In The Diagnosis Of Post-hepatitis B Cirrhosis Compensation Period

Objective :To investigate the liver stiffness measurement(liver stiffness measurement,LSM),the maximum cross-section diameter of portal vein(protal vein diameter,PVD)and the average blood flow velocity(protal vein velocity,PVV),etc.The value and correlation of ultrasound imaging indexes,serological indexes hyaluronic Acid(hyaluronan,HA),serological model APRI Index and other indexes in the diagnosis of compensatory period of liver cirrhosis after hepatitis B were analyzed,and the value of the combined use of the four indexes was analyzed.Methods: A total of 105 patients with confirmed chronic hepatitis B and hepatitis B cirrhosis were selected as subjects,including 35 cases of chronic hepatitis,37 cases of cirrhosis compensation period and 33 cases of decompensated cirrhosis.At the same time,35 cases of health examination were selected as control group in the same period of medical Examination center of our hospital.The values of platelet count(bloodplatelecount,BPC)and glutamate transferase(aspartate aminotransferase,AST)were detected,and the APRI model was composed of AST and BPC,and the formula was Apri index =(AST/ULN*100)/BPC,serum hyaluronic acid(hyaluronic Acid,ha),detected by fixed professionals using solid-phase Radioimmunoassay,B-ultrasonography to check the protal vein diameter(PVD)and protal vein velocity(PVV)of the hepatic portal vein,using Siemens Determination of S1000 Color Doppler ultrasound diagnostic instrument.Firstly,the imaging index was analyzed,the liver stiffness measurement(LSM)was detected by the hepatic instantaneous elastic imaging detector(fibroscan,FS),the protal vein diameter(PVD)and the protal vein velocity(PVV)of the portal vein were analyzed,and the serological index ha and apri data were analyzed.Finally,the value of imaging index LSM,PVD and PVV,and serological index HA,APRI index(including AST and BPC)in the diagnosis of cirrhosis after early hepatitis was analyzed,and its correlation.Firstly,the imaging indexes of patients,including the hepatic elastic value(LSM)and the maximum cross-section diameter(PVD)and the average blood flow velocity(PVV)of the portal vein detected by the hepatic instantaneous elastic imaging Detector(fibroscan,FS),as well as the serological index HA and APRI data,were analyzed.The four indexes were compared in normal group and three group of Liver disease Group,followed by analysis of the correlation between LSM and other indexes in compensatory stage Cirrhosis Group,re-analysis of the performance of LSM,PVV and serological index HA and APRI index in each group,and finally analyzed the value of the joint use of the four indexes.Results:1.The LSM,PVV,HA and APRI of patients with liver disease were significantly higher than those in normal control group(P<0.01),and the LSM,PVV,HA and APRI were gradually elevated from normal group to different stages of chronic liver disease(chronic hepatitis,decompensated cirrhosis and decompensated cirrhosis).The difference between the normal group and the liver Disease Group was significant,and the difference was significant in the group of liver disease(from chronic hepatitis Group to decompensated cirrhosis Group,to decompensated cirrhosis Group),and 22 in the comparison between the groups(p ? 0.01).Liver cirrhosis According to Child-Pugh classification is divided into A,B,C three class,A grade is compensatory period,B,C period is decompensated period,clinical in order to express convenience,respectively called cirrhosis compensation period(phase A)for the early stage of cirrhosis,cirrhosis decompensated period(B,C stage)for the late cirrhosis.2.The changes of protal vein velocity(PVV)of the portal vein in each group of patients with liver disease were contrary to the changes in the exact LSM values,and in different stages(chronic hepatitis,decompensated cirrhosis and decompensated cirrhosis),the PVV values decreased gradually with the progression of the disease,the normal group and the chronic liver disease in each 22 group of liver disease The difference was significant(p ? 0.01),and the difference of 22 in chronic liver disease was also significant(p?0.01),and the maximum cross-section diameter(PVD)of portal vein increased gradually with the progression of liver disease,and the difference was significant between the normal group and the group of Chronic Liver Disease Group 22,(p?0.01),The difference between the groups of chronic liver disease group in 22 was significant,(p?0.01).3.In the compensatory stage cirrhosis group,there was a correlation between LSM and PVV,HA and APRI indices.LSM is negatively correlated with PVV,correlation index-0.826,good correlation.The LSM was positively correlated with the HA,APRI index value,and the correlation coefficients were 0.553,0.761,0.517 respectively,and the cues were helpful to the diagnosis of compensatory stage cirrhosis group.4.The sensitivity and specificity of LSM and PVV,HA and APRI index increased gradually in the normal group to decompensated cirrhosis group,and the sensitivity of cirrhosis group was higher in the compensatory stage,69.24%~79.24%,and the sensitivity was raised from the lowest 87.12% to 92.37% in the combination of index 22 and four joint use.Indicates an increase in the accuracy of diagnosis of cirrhosis during compensatory period.Conclusion: The indexes were compared between the normal group and the liver Disease group,as well as the group of Liver Disease Group,and the difference was significant(p ? 0.01).These indexes can be used alone to diagnose the following changes in the disease: normal condition to chronic hepatitis,and then to compensatory stage cirrhosis and decompensated cirrhosis of the four stages,and the correlation is good,with the progression of the disease,the sensitivity of the indicator gradually increased,suggesting that the accuracy of diagnosis is rising.All indexes were most obviously diagnosed in the late stage of cirrhosis.Comparing the two indexes and four joint,the sensitivity and specificity of the decompensated cirrhosis were significantly higher than that of the normal group,and the sensitivity and specificity were more than90%,suggesting that the combined method was more accurate in diagnosing the compensation period cirrhosis.This study infers that the combination of these imaging indexes and serological indexes in the diagnosis of cirrhosis,especially in compensatory stage cirrhosis,has some practical clinical significance and may partially replace liver puncture.