脾脏硬度对肝硬化食管静脉曲张的预测价值

目的 评估脾脏硬度对肝硬化患者食管静脉曲张(EV)的预测价值.资料与方法 回顾性分析80例慢性乙肝肝硬化患者的胃镜检查、Fibro Touch检查与血清学检查资料.以胃镜检查结果为"金标准",将患者分为EV组和非EV组,比较两组患者肝脏硬度值(LSM)和脾脏硬度值(SSM);计算纤维化4项指标(FIB-4)、天冬氨酸氨...

Prediction of Spleen Stiffness Measurement for Esophageal Varices in Cirrhosis

Purpose To evaluate the value of spleen stiffness measurement in predicting esophageal varices(EV)of patients with cirrhosis.Materials and Methods Gastroscopy,Fibro Touch and serological examination of 80 patients with chronic hepatitis B cirrhosis were retrospectively analyzed.The results of endoscopy were used as the“gold standard”,all patients were divided into EV group and non-EV group.Liver stiffness measurement(LSM)and spleen stiffness measurement(SSM)were compared between the two groups.The fibrosis index based on factor 4(FIB-4)and aspartate aminotransferase and platelet ratio index(APRI)were calculated.The correlation of the four indexes was discussed.Then the predictive value of SSM and LSM,alone or in combination with serological indicators were compared.Results The LSM,SSM,APRI and FIB-4 in EV group(n=66)were significantly higher than those in non-EV group(n=14)(P<0.05).SSM was positively correlated with LSM,APRI and FIB-4(r=0.680,0.415 and 0.227,P<0.05).Logistic regression analysis showed that SSM was the only influencing factor for EV prediction(P=0.001).The area under the receiver operating characteristic curve(AUC)of LSM,SSM,FIB-4 and APRI were 0.816,0.880,0.733 and 0.732,respectively.The AUC of SSM was higher than that of FIB-4 and APRI(P<0.05),but the difference was not statistically significant compared with LSM(P>0.05).The AUC of the combined indicator LSM+FIB-4,LSM+APRI,SSM+APRI and SSM+FIB-4 were 0.832,0.832,0.878,0.887,respectively.The AUC of SSM+FIB-4 combined diagnostic model was the highest,significantly higher than that of single serological index(P<0.05),but there was no significant difference with LSM,SSM or other three combined indexes(P>0.05).Conclusion SSM measured by Fibro Touch has good clinical value in predicting the presence of EV in patients with chronic hepatitis B cirrhosis,and its predictive value is similar to that of LSM.