Abstract: Objective To study the relationship between the elasticity of hepatitis B patients with different alanine transaminase (ALT), gallbladder disease and spleen size by shear wave elastography (SWE). Method Select hepatitis B patients with elevated liver elasticity who visited Shenzhen Second People's Hospital from December 2018 to December 2022, the patients were divided into normal group (N group) 107 cases, high but not more than twice the normal value group (Ha group) 34 cases and more than twice the normal value group (Hb group) 25 cases according to the ALT level. Analyze the impact of liver elasticity values on the incidence of gallbladder disease and spleen size in each group, and analyze the correlation between liver elasticity values and spleen thickness. Result ①There was no statistically significant difference in gender composition ratio, gallbladder disease incidence, and spleen size among the N, Ha, and Hb groups (P>0.05), but there was a statistically significant difference in age distribution (P=0.010). ②The liver elasticity value and age of positive patients with gallbladder disease in group N were significantly higher than those of negative patients (P<0.001, P=0.005), and after adjusting for age, liver elasticity value was a risk factor for gallbladder disease (OR=1.167, P=0.040); The elasticity values of liver in group N with splenomegaly were significantly higher than those with the spleen is not swollen (P=0.006) and the elasticity value was a risk factor for splenomegaly (OR=1.221, P=0.004). ③The liver elasticity value of Hb group with splenomegaly was significantly higher than that of the spleen is not swollen (P=0.021). The liver elasticity value is a risk factor for splenomegaly (OR=1.327, P=0.026), and the liver elasticity value is moderately correlated with splenic thickness (r=0.580, P=0.002). ④A ROC curve was drawn based on the liver elasticity value and gallbladder disease incidence in group N, with an area under the curve of 0.704. The optimal intervention treatment threshold was 7.350, and the corresponding sensitivity and specificity were 68.0% and 66.7%. ⑤The ROC curve of the subjects was drawn based on the liver elasticity value and splenomegaly incidence of the N and Hb groups. The area under the curve was 0.660 and 0.773, respectively. The optimal intervention treatment thresholds were 7.450 and 12.500, with corresponding sensitivity of 61.5% and 72.7%, and specificity of 67.6% and 92.9%, respectively. Conclusion In hepatitis B patients with normal ALT level, gallbladder disease and spleen size are related to liver elasticity; In patients with hepatitis B whose ALT level is twice the normal value, the liver elasticity value is moderately related to the thickness and diameter of the spleen. Early treatment of such patients may help reduce the incidence rate of biliary and splenic diseases.

Key words: Shear wave elastography, Alanine transaminase, Hepatitis B, Gallbladder disease