ARFI测量肝脾硬度与HVPG的相关性分析

发布时间：2018-01-31 06:59

  本文关键词： 肝硬化 声脉冲辐射力成像技术 肝静脉压力梯度 无创诊断　出处：《东南大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：探讨通过ARFI测定的肝脾硬度与HVPG的相关性及其诊断门静脉高压的效能。方法：对2014年4月至2016年3月在南京鼓楼医院消化内科接受HVPG测定的20例肝硬化门脉高压的患者术前运用ARFI测量肝脏硬度(Liver Stiffness,LS)及脾脏硬度(Spleen Stiffness,SS).患者术前同时行肝功能、血常规及凝血功能等检查。分析患者的年龄、ALT、AST、总胆红素、白蛋白、血小板计数、PT、APRI (AST/Plt)、Child评分、MELD评分、LS、SS与反映门脉压力的HVPG之间的相关性。结果：20例患者均成功测得了HVPG数值及肝、脾硬度。年龄、ALT、AST、血小板计数、PT、APRI、 Child评分、MELD评分与HVPG无显著相关性。LS及SS与HVPG显著相关(P0.05)。将LS及SS设为自变量,构建预测HVPG的多元线性回归模型为：HVPG=-20.871+10.66*LS+5.32*SS。在预测HVPG≥12mmHg时,LS及SS的ROC曲线下面积分别为0.875和0.711。LS最佳界值点为1.77m/s(敏感性为68.8%、特异性为100%)。SS最佳界值点为3.18m/s(敏感性为68.8%、特异性75%)。在预测HVPG≥20mmHg时,LS及SS的ROC曲线下面积分别为0.798和0.820。LS最佳界值点为1.85m/s(敏感性为100%、特异性为68.7%)。SS最佳界值点为3.23m/s(敏感性为100%、特异性为56.2%)。结论：肝硬化患者中,ARFI测得的肝脏及脾脏硬度与HVPG相关,在门静脉高压的无创诊断中具有一定应用价值。
[Abstract]:Objective: to investigate the correlation between liver and spleen hardness determined by ARFI and HVPG and its effectiveness in the diagnosis of portal hypertension. From April 2014 to March 2016, 20 patients with hepatic cirrhosis and portal hypertension who were examined by HVPG in the Department of Gastroenterology, Nanjing Gulou Hospital, were examined for liver hardness by ARFI before operation. Liver Stiffness. LS) and Spleen Stiffnessen SSS. Liver function, blood routine examination and coagulation function were performed simultaneously before operation. The age of the patients was analyzed. Total bilirubin, albumin, platelet count, PTT APRI / AST / Pltn Child score, meld score and LS. Results the values of HVPG, liver and spleen hardness, alt AST, platelet count and PT were measured successfully in 20 patients. There was no significant correlation between meld score and HVPG. LS and SS were significantly correlated with HVPG (P 0.05). LS and SS were regarded as independent variables. The multivariate linear regression model for predicting HVPG was established as: HVPG 鈮，

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