高级检索

声触诊弹性成像与肝脏纤维化评分评估肝硬化高风险食管静脉曲张的比较

Comparison of sound touch elastography and liver fibrosis scores in assessing high-risk esophageal varices in patients with liver cirrhosis

    摘要
  • 摘要:
    目的 比较声触诊弹性成像（STE）与肝脏肝纤维化评分（APRI、FIB-4）对肝硬化高风险食管静脉曲张（HREV）的诊断效能，为STE的临床应用提供循证依据。
    方法 纳入2018年8月至2021年12月在中山大学附属第三医院就诊的肝硬化患者148例。采集其临床资料、血清学指标，并进行电子胃镜、腹部超声及声触诊弹性成像检测肝脏及脾脏硬度。以胃镜为金标准，采用Logistic回归分析HREV的独立危险因素并构建回归模型。以受试者操作特征（ROC）曲线下面积（AUC）评价各无创模型对HREV的诊断效能。
    结果 脾脏硬度、血小板计数（PLT）是HREV的独立危险因素，建立诊断HREV的回归模型logit P = 0.125×脾脏硬度（kPa）−0.018×PLT（×109/L）−2.262。肝脏硬度、脾脏硬度、回归模型、APRI、FIB-4诊断HREV的AUC分别为0.67 (0.59 ， 0.75)、0.83 (0.76 ， 0.88)、0.86 (0.79 ， 0.91)、0.69 (0.61 ， 0.76)、0.75 (0.68 ， 0.82)。
    结论 基于脾脏硬度和血小板指数的回归模型对预测肝硬化HREV的发生具有较高诊断价值，其效能优于APRI与FIB-4。

     

    Abstract:
    Purpose To evaluate and compare the diagnostic efficiency of sound touch elastography (STE) and liver fibrosis scores (APRI, FIB-4) for high-risk esophageal varices (HREV) in patients with liver cirrhosis, providing evidence for clinical application of STE.
    Methods 148 patients diagnosed with liver cirrhosis in the Third Affiliated Hospital of Sun Yat-sen University between August 2018 and December 2021 were included. Clinical data and serological results were collected. Patients underwent electronic gastroscopy, abdominal ultrasound, and STE examinations for liver/spleen stiffness measurement. With gastroscopy as the gold standard, Logistic regression was performed to identify the independent risk factors for HREV, and construct the regression model. The area under the receiver operating characteristic (ROC) curve (AUC) was used to assess the diagnostic efficiency of each non-invasive model.
    Results Spleen stiffness and platelet count (PLT) were the independent risk factors of HREV. The regression model was established as Logit P = 0.125 × spleen stiffness (kPa)−0.018 × PLT (×109/L)−2.262. The AUC for liver stiffness, spleen stiffness, the regression model, APRI, and FIB-4 was 0.67 (0.59, 0.75), 0.83 (0.76, 0.88), 0.86 (0.79, 0.91), 0.69 (0.61, 0.76) and 0.75 (0.68, 0.82), respectively.
    Conclusion The regression model based on spleen stiffness and PLT shows high diagnostic value for HREV in patients with liver cirrhosis, which outperforms APRI and FIB-4.

     

    • HTML全文
    • 参考文献(30)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回