利用Fibroscan对肝、脾硬度测定探讨其与食管静脉曲张程度的关系

发布时间：2018-05-07 10:01

本文选题：肝硬化 + 食管静脉曲张　；参考：《石河子大学》2017年硕士论文

【摘要】：目的通过Fibro Scan(FS)测定肝硬化食管静脉曲张患者肝、脾硬度,以及食管静脉曲张硬化治疗术后复查肝脾硬度,探讨肝脾硬度与食管静脉曲张程度的关系,同时本研究还探讨了肝脏硬度于肝脏脂肪度(CAP)的相关性。方法选择101例肝硬化患者进行胃镜检查,确定无食管静脉曲张组、轻度、中度、重度食管静脉曲张组,并利用FS对四组患者进行肝、脾硬度测定,并对其中11例行食管静脉曲张硬化治疗后的患者再次进行肝、脾硬度复查,测定肝脏硬度的同时收集肝脏脂肪度。结果无食管静脉曲张组30人,其中轻度17人,中度27人,重度27人,其肝、脾硬度均与食管静脉曲张程度有明显相关性,并随食管静脉曲张程度加重而增大,经ROC曲线分析,肝、脾硬度曲线下面积(AUC)均大于0.7,但脾脏硬度评估中重度食管静脉曲张最佳界值38.2KPa,曲线下面积0.958,特异度93.6%,灵敏度96.3%,95%CI为(0.919,0.997),均高于肝脏硬度。本研究对101例肝硬化患者的肝脏脂肪度测定发现肝脏硬度值与肝脏脂肪度的关系r=-0.138,P=0.168。结论1.利用FS测定肝、脾硬度对肝硬化患者食管静脉曲张评估均有一定准确性;2.脾脏硬度的预测效果更为准确,且值得临床进一步研究及推广;3.肝硬化患者肝脏硬度与肝脂肪度无明显相关。
[Abstract]:Objective to study the relationship between hepatic and splenic hardness and esophageal varicose degree in patients with hepatic cirrhosis and esophageal varices by Fibro scanning FSs, and to determine the hardness of liver and spleen in patients with esophageal varices, and to investigate the relationship between the hardness of liver and spleen and the degree of esophageal varices after the treatment of esophageal varices. At the same time, the relationship between liver hardness and liver fat degree (CAP) was also investigated. Methods 101 patients with liver cirrhosis were examined by gastroscopy. The patients without esophageal varices, mild, moderate and severe esophageal varices were selected. The liver and spleen hardness of four groups were measured by FS. The liver and spleen hardness of 11 patients who were treated with esophageal varicosclerotic therapy were rechecked and the liver fat was collected while the liver hardness was measured. Results there were 30 patients without esophageal varices, including 17 mild, 27 moderate and 27 severe. The hardness of liver and spleen was significantly correlated with the degree of esophageal varices, and increased with the severity of esophageal varices, and was analyzed by ROC curve. The area under the hardness curve of liver and spleen was greater than 0.7, but the best threshold value of esophageal varices was 38.2 KPa. under the curve, the area under the curve was 0.958, the specificity was 93.6 and the sensitivity was 96.39.95 CI was 0.919 ~ 0.997g, which was higher than that of liver hardness. In this study, the relationship between liver hardness and liver fat was found in 101 patients with liver cirrhosis. Conclusion 1. Using FS to determine liver and spleen hardness has a certain accuracy in evaluating esophageal varices in patients with liver cirrhosis. The prediction effect of spleen hardness is more accurate and worthy of further clinical study and promotion. There was no significant correlation between liver hardness and liver fat degree in patients with liver cirrhosis.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575.2

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