ARFI技术与血清铁、铁蛋白和肝纤维化四项检测在肝纤维化及肝硬化诊断中的相关性

目的：探讨声脉冲辐射力成像技术（ acoustic radiation force impulse imaging ，ARFI）、血清铁、铁蛋白及肝纤维化四项指标（Ⅲ型前胶原、Ⅳ型胶原、层黏蛋白、透明质酸）在诊断肝纤维化及肝硬化中的相关性。方法在2013年6-10月期间，选取20例正常者作为对照组和53例肝纤维化、肝硬化作为观察组。所有研究对象均进行上述7项指标的检测，比较对照组和观察组组间测量指标的差异；将观察组ARFI测量值与血清铁、铁蛋白、肝纤维化四项指标进行相关性分析。结果观察组的ARFI、血清铁、铁蛋白、Ⅲ型前胶原、Ⅳ型胶原、层黏蛋白和透明质酸的测值均高于对照组（ P均＜0.01）；观察组的ARFI分别与透明质酸（r＝0．48，P＜0．01）、层黏蛋白（r＝0．44，P＜0．01）、Ⅳ型胶原（r＝0．41，P＜0．01）和血清铁（r＝0.33，P＜0.05）均存在正相关；但与Ⅲ型前胶原（r＝0．07，P＞0．05）和铁蛋白（r＝0．12，P＞0．05）不存在相关性。结论 ARFI技术可无创反映肝组织的弹性硬度，且与透明质酸、层黏蛋白、Ⅳ型胶原、血清铁相关性良好，对肝纤维化及肝硬化的诊断具有一定临床价值。

Analysis of the correlation between ARFI and four indexes of serum liver fibrosis in the diagnosis of liver diseases

Objective To explore the correlation of acoustic radiation force impulse imaging （ARFI）,serum iron and ferritin, four indexes of serum liver fibrosis （type Ⅲcollagen,typeⅣ collagen,layer before mucins,hyaluronic acid） in the diagnosis of liver diseases.Methods A total of 20 health adults were collected as the control group and 53 cases of patients with hepatic fibrosis or liver cirrhosis were collected as hepatopathy group from Jun to Oct 2013.All subjects were measured by seven ARFI ,serum iron and ferritin, four indexes of serum liver fibrosis .The difference of measurement results between control and case group was compared ,and the corre-lation of ARFI results with serum iron ,ferritin and four indexes of serum liver fibrosis were assessed .Results The levels of ARFI ,ser-um iron,ferritin and four indexes of serum liver fibrosis in case group are higher than that in control group and the difference is statisti -cally significant （P〈0.05）.A significant linear correlation was found between ARFI results and hyaluronic acid （r =0.48,P 〈0.01）,laminin （r=0.44,P〈0.01）,collagen type Ⅳ（r=0.41,P〈0.01） and serum ferritin （r=0.33,P〈0.05）,while non-sig-nificant linear correlation was found with procollagen ⅢN-terminal peptide （r=0.07,P〉0.05） and serum albumin （r=0.12,P〉0.05）.Conclusion ARFI technology test could be used to analyze quantitatively liver fibrosis without liver biopsy .The technique will provide a certain clinical value in the diagnosis of chronic liver disease .