肝豆状核变性患者肝脏剪切波速度与实验室指标间的相关性研究

目的:通过声触诊组织量化技术(virtual touch tissue quantification,VTQ)测量肝豆状核变性(hepatolenticular degeneration,HLD)患者肝脏组织的剪切波速度(shear wave velocity,SWV)来评估肝脏的质地,并探讨HLD患者肝脏SWV与铜生化指标、血清肝纤维化指标之间是否存在相关性。方法:采用西门子ACUSON-S2000型彩色多普勒超声诊断仪,系统配有声脉冲辐射力成像技术。对HLD患者的肝脏右后叶进行VTQ检测,记录SWV值,并测量HLD患者铜生化指标中的血清铜离子(copperion,Cu2+)、铜蓝蛋白(ceruloplasmin,CP)、铜氧化酶(copper oxidase,SCO)三项指标以及肝纤维化中的Ⅲ型前胶原(procollagen type Ⅲ,PC-Ⅲ)、Ⅳ型胶原(collagen type Ⅳ,Ⅳ-C)、层黏蛋白(laminin,LN)以及透明质酸(hyaluronic acid,HA)四项指标,应用SPSS18.0软件分析SWV值与Cu2+、CP、SCO以及PC-Ⅲ、Ⅳ-C、LN、HA之间是否存在相关性。结果:肝脏SWV值与Cu2+、CP均无相关关系(P>0.05),与SCO值呈负相关(P<0.05);SWV值与肝脏纤维化四项指标(PC-Ⅲ、Ⅳ-C、LN、HA)均呈正相关关系(P<0.05~P<0.01)。结论:超声VTQ技术,可在一定程度上反映HLD患者铜的转运活力及肝脏的纤维化程度,在HLD的诊断和病情判断中有着较高的临床应用价值。

Correlation of liver SWV with laboratory indexes in hepatolenticular degeneration patients

Objective:To measure the liver shear wave velocity(SWV) in hepatolenticular degeneration(HLD) patients by virtual touch tissue quantification(VTQ) technology,evaluate the texture of the liver,and explore the correlations of liver SWV with copper biochemical indicators and serum liver fibrosis indexes. Methods:The SWV value in HLD patients was recorded by Siemens ACUSON-S2000 color doppler ultrasonic diagnostic instrument,which was equipped with the acoustic radiation force impulse imaging software and VTQ technology. The copper biochemical indicators including copper ion(Cu2+),ceruloplasmin(CP),and copper oxidase(SCO) and serum liver fibrosis indexes including procollagen type Ⅲ(PC-Ⅲ),collagen type Ⅳ(Ⅳ-C),laminin(LN) and hyaluronic acid(HA) were measured. The correlation of the liver SWV value with Cu2+,CP,SCO,PC-Ⅲ,Ⅳ-C,LN and HA were analyzed. Results:The liver SWV value was not correlation with Cu2+ and CP(P>0. 05),negative correlation with SCO value(P<0. 05). The SWV value was positive correlation with serum liver fibrosis indexes(PC-Ⅲ,Ⅳ-C,LN and HA)(P<0. 05 to P<0. 01). Conclusions:The ultrasound VTQ technology can reflect the Cu2+ transport activity and liver fibrosis degree to a certain extent,which has high clinical application value in the diagnosis of HLD.