声触诊组织量化技术（VTQ）测量肝硬度与血清AST/ALT比值评价肝硬化患者严重程度及预后分析

摘要 目的：探讨VTQ测量肝硬度与血清AST/ALT比值对肝硬化患者严重程度及预后的评价价值。方法：回顾性选择2018年1月至2022年10月来我院诊治的肝硬化患者80例，根据Child-Pugh分级将80例患者分为Child-Push A级30例、B级25例、C级25级，根据是否存在并发症将80例患者分为并发症组（45例）与非并发症组（35例），80例患者均用VTQ法检测VTQ值，检测所有患者的血清ALT、AST水平，计算ALT/AST比值。对比不同Child-Push分级患者不同部位的VTQ值，对比不同Child-Push分级患者的AST、ALT水平及AST/ALT比值，对比有无并发症组的不同部位VTQ值，对比有无并发症组患者的AST、ALT水平及AST/ALT比值，分析80例患者不同部位VTQ值与AST、ALT、AST/ALT比值的相关性。结果：C组患者不同肝脏部位的VTQ值明显较A组及B组高，B组患者不同肝脏部位的VTQ值较A组高（P<0.05）。C组的AST水平、AST/ALT值明显较A组、B组高，B组的AST水平、AST/ALT值明显较A组高（P<0.05），C组的ALT水平较A组、B组高，B组的ALT水平较A组高，但组间对比无统计学意义（P>0.05）。并发症组不同肝脏部位的VTQ值明显较无并发症组高（P<0.05）。并发症组的AST、AST/ALT比值明显较无并发症组高（P<0.05），并发症组的ALT较无并发症组高，但组间对比无统计学意义（P>0.05）。80例肝硬化患者的AST、AST/ALT比值与不同部位的VTQ值正相关（P<0.05），ALT水平与不同部位的VTQ值无相关性（P>0.05）。结论：VTQ测量肝硬度与血清AST/ALT比值可用于评价肝硬化严重程度及预后。

Sound Palpation Tissue Quantification (VTQ) Used to Measure Liver Hardness and Serum AST/ALT Ratio to Evaluate the Severity and Prognosis of Patients with Cirrhosis

ABSTRACT Objective: To investigate the value of VTQ measurement of liver hardness and serum AST/ALT ratio in evaluating the severity and prognosis of patients with cirrhosis. Methods: 80 patients with cirrhosis admitted to our hospital from January 2018 to October 2022 were retrospectively selected. According to Child-Pugh classification, 80 patients were divided into Child-Push grade A (30 cases), Grade B (25 cases) and grade C (25 cases). According to the existence of complications, 80 patients were divided into complication group (45 cases) and non-complication group (35 cases). The VTQ values were detected by VTQ method in all 80 patients. The serum ALT and AST levels were detected in all patients, and ALT/AST ratio was calculated. The VTQ values of different parts of patients with different Child-Push grades, AST and ALT levels and AST/ALT ratio of patients with different Child-Push grades, VTQ values of different parts of patients with or without complications, AST and ALT levels and AST/ALT ratio of patients with or without complications were compared, and VTQ values of patients with or without complications were compared. The correlation between VTQ value and AST, ALT and AST/ALT ratio in different parts of 80 patients was analyzed. Results: The VTQ value of different liver parts in group C was significantly higher than that in group A and B, and the VTQ value of different liver parts in group B was higher than that in group A (P<0.05). The AST level and AST/ALT value in group C were significantly higher than those in groups A and B; the AST level and AST/ALT value in group B were significantly higher than those in group A(P<0.05); the ALT level in group C was higher than that in groups A and B; the ALT level in group B was higher than that in group A, while there was no statistical significance between groups (P>0.05). The VTQ values of different liver parts in complication group were significantly higher than those in non-complication group (P<0.05). The AST and AST/ALT ratios in the complication group were significantly higher than those in the non-complication group (P<0.05), and the ALT in the complication group was higher than that in the non-complication group, but there was no statistical significance between the groups (P>0.05). The AST and AST/ALT ratios of 80 patients with cirrhosis were positively correlated with VTQ values of different sites (P<0.05), while there was no correlation between ALT levels and VTQ values of different sites(P>0.05). Conclusion: VTQ measurement of liver hardness and serum AST/ALT ratio can be used to evaluate the severity and prognosis of patients with cirrhosis.