Song Seung Ju, Kim Youe Ree, Lee Young Hwan, Cho Eun Young
Department of Radiology, Wonkwang University Hospital, Wonkwang University College of Medicine, Iksan, Korea.
Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University College of Medicine, Iksan, Korea.
Ultrasonography. 2024 Sep;43(5):384-392. doi: 10.14366/usg.24091. Epub 2024 Jul 15.
This study assessed the use of liver stiffness (LS) and dispersion slope (DS) in classifying patients with chronic hepatitis B (CHB) by the necessity of antiviral treatment.
A retrospective review examined 249 patients with CHB (male:female, 107:142; mean age, 53±14 years) between April 2018 and March 2022. Patients for whom treatment was indicated, termed group 1, exhibited either serum alanine transaminase (ALT) and aspartate aminotransferase levels not exceeding five times the upper limit of normal and LS >13 kPa, or hepatitis B virus DNA >2,000 IU/mL and ALT >40 IU/L. The remaining patients comprised group 2 (treatment not required). In subgroup analysis, patients with LS <13 kPa were further examined.
Overall, group 1 exhibited significantly higher LS (12.64±6.76 vs. 6.31±1.67 kPa, P<0.001) and DS (15.52±4.95 vs. 11.04±1.93 [m/s]/kHz, P<0.001) than group 2. In subgroup analysis, group 1 also demonstrated significantly higher values (LS: 8.05±2.12 vs 6.31±1.67 kPa, P<0.001, DS: 13.06±2.75 vs. 11.04±1.93 [m/s]/kHz, P<0.001). The areas under the curve (AUCs) for LS and DS in group 1 were 0.855 (95% confidence interval [CI], 0.80 to 0.90; P<0.001) and 0.810 (95% CI, 0.75 to 0.86; P<0.001), respectively. In subgroup analysis, the AUCs for LS and DS in group 1 were 0.751 (95% CI, 0.69 to 0.81; P<0.001) and 0.711 (95% CI, 0.64 to 0.77; P<0.001), respectively. Within group 1, the AUCs for LS and DS did not differ significantly (P>0.05).
LS and DS assist in classifying patients with CHB by their need for antiviral treatment.
本研究通过评估肝硬度（LS）和离散斜率（DS），根据抗病毒治疗的必要性对慢性乙型肝炎（CHB）患者进行分类。
一项回顾性研究对2018年4月至2022年3月期间的249例CHB患者（男∶女为107∶142；平均年龄53±14岁）进行了检查。有治疗指征的患者归为第1组，其血清丙氨酸转氨酶（ALT）和天冬氨酸转氨酶水平不超过正常上限的5倍且LS>13 kPa，或乙肝病毒DNA>2000 IU/mL且ALT>40 IU/L。其余患者为第2组（无需治疗）。在亚组分析中，对LS<13 kPa的患者进行了进一步检查。
总体而言，第1组的LS（12.64±6.76 vs. 6.31±1.67 kPa，P<0.001）和DS（15.52±4.95 vs. 11.04±1.93 [m/s]/kHz，P<0.001）显著高于第2组。在亚组分析中，第1组的值也显著更高（LS：8.05±2.12 vs 6.31±1.67 kPa，P<0.001，DS：13.06±2.75 vs. 11.04±1.93 [m/s]/kHz，P<0.001）。第1组中LS和DS的曲线下面积（AUC）分别为0.855（95%置信区间[CI]，0.80至0.90；P<0.001）和0.810（95%CI，0.75至0.86；P<0.001）。在亚组分析中，第1组中LS和DS的AUC分别为0.751（95%CI，0.69至0.81；P<0.001）和0.711（95%CI，0.64至0.77；P<0.001）。在第1组内，LS和DS的AUC无显著差异（P>0.05）。
LS和DS有助于根据抗病毒治疗需求对CHB患者进行分类。
