应用CT图像预测乙型肝炎肝硬化患者门脉压力研究

发布时间：2018-04-04 02:04

本文选题：肝硬化　切入点：静脉曲张破裂出血　出处：《中国实用内科杂志》2015年03期

【摘要】：目的旨在寻找一种准确而有效地预测肝静脉压力梯度(HVPG)值的非侵入性方法。方法以2012年9月至2014年5月在山东大学附属省立医院消化内科收集的75例乙型肝炎肝硬化患者为研究对象。所有患者均行CT扫描和HVPG测量,检测肝功、凝血酶原时间(PT)和血小板计数,计算Child-Pugh评分。应用CT图像测量患者的肝脏体积、脾脏体积、门静脉宽度和脾静脉宽度。评估所有变量预测HVPG值的能力,选取预测能力强的变量建立HVPG预测方程。结果 HVPG评分=18.912-7.173×ln(肝脏体积/脾脏体积),该HVPG预测方程的曲线下面积(AUC)、敏感度、特异度、阳性预测值和阴性预测值分别是0.906,92.9%,79.2%,83.9%和90.5%。结论应用肝脾体积比能够预测乙型肝炎肝硬化患者的HVPG值。该预测模型可能作为一种新的预测HVPG值的方法应用于临床。
[Abstract]:Objective to find an accurate and effective noninvasive method for predicting HVPGs of hepatic vein pressure gradient.Methods from September 2012 to May 2014, 75 patients with hepatitis B cirrhosis were collected from the Department of Digestive Medicine, affiliated Hospital of Shandong University.All patients were examined by CT and HVPG. Liver function, prothrombin time and platelet count were measured. Child-Pugh score was calculated.Ct images were used to measure the liver volume, spleen volume, portal vein width and splenic vein width.To evaluate the ability of all variables to predict the HVPG value, the HVPG prediction equation is established by selecting the variables with strong predictive ability.Results HVPG score was 18.912-7.173 脳 ln (liver volume / spleen volume). The area under the curve of the HVPG prediction equation was 0.9067.173 脳 ln, sensitivity, specificity, positive predictive value and negative predictive value were 83.9% and 90.5%, respectively.Conclusion the application of liver-spleen volume ratio can predict the HVPG value in patients with hepatitis B cirrhosis.This prediction model may be used as a new method for predicting HVPG value in clinic.
【作者单位】：山东大学附属省立医院消化内科;
【基金】：国家自然科学基金资助(81370554)
【分类号】：R575.2;R512.62

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