剪切波弹性成像定量分析妊娠期胆汁淤积症孕妇肝损伤的临床初步研究

A Preliminary Clinical Study on Quantitative Analysis of Liver Injury in Pregnant Women with Intrahepatic Cholestasis of Pregnancy Using Shear Wave Elastography

摘要: 目的：探讨剪切波弹性成像(SWE)技术对妊娠期胆汁淤积症(ICP)孕妇肝损伤的定量评估价值。方法：纳入30例ICP孕妇(ICP组)及30例健康单胎孕妇(对照组)，应用SWE技术测量肝脏硬度值，并检测血清总胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)等传统肝功能指标，分析SWE值与肝功能指标的相关性。结果：ICP组的SWE弹性值显著高于对照组(P < 0.01)，分别为8.72 ± 2.03 kPa和6.26 ± 0.67 kPa。SWE弹性值与TBA、ALT、AST、GGT和TBIL均呈正相关，相关系数分别为0.87、0.79、0.81、0.85和0.76。结论：SWE技术可通过无创定量检测肝脏硬度有效评估ICP孕妇肝损伤程度，其弹性值与胆汁淤积严重程度相关，为ICP的临床诊断及病情监测提供了客观影像学依据。

Abstract: Objective: To investigate the value of shear wave elastography (SWE) in quantitatively assessing liver injury in pregnant women with intrahepatic cholestasis of pregnancy (ICP). Methods: Thirty ICP pregnant women (ICP group) and thirty healthy singleton pregnant women (control group) were enrolled. Liver stiffness was measured using SWE. Traditional liver function indices, including serum total bile acid (TBA), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and total bilirubin (TBIL) were detected. The correlation between SWE values and liver function indices was analyzed. Results: The SWE elasticity value in the ICP group was significantly higher than that in the control group (8.72 ± 2.03 kPa vs. 6.26 ± 0.67 kPa, P < 0.01). The SWE elasticity value showed positive correlations with TBA, ALT, AST, GGT, and TBIL, with correlation coefficients of 0.87, 0.79, 0.81, 0.85, and 0.76, respectively. Conclusion: SWE technology can effectively assess the degree of liver injury in ICP pregnant women through non-invasive quantitative measurement of liver stiffness. The SWE elasticity value correlates with the severity of cholestasis, providing an objective imaging basis for the clinical diagnosis and monitoring of ICP.