脾脏硬度与接受抗病毒治疗乙肝肝硬化患者食管胃底静脉曲张的关系

发布时间：2018-05-09 02:22

本文选题：肝硬化 + 乙肝肝硬化　；参考：《实用医学杂志》2015年07期

【摘要】：目的:探讨应用瞬时弹性扫描仪(Fibro Scan,FS)检测脾脏硬度对接受抗病毒治疗乙肝肝硬化患者食管胃底静脉曲张(esophageal varices,EV)的诊断价值。方法:2014年1-12月我院肝病科门诊或住院接受抗病毒治疗乙肝肝硬化患者41例纳入本项研究。使用FS测量脾脏及肝脏弹性值,同时进行胃镜检查。以胃镜检查结果为金标准计算脾脏FS值与肝脏FS值的受试者工作特征曲线下面积(area under receiver operating characteristic curve,AUROC),评价其对EV及其程度的预测价值。结果:脾脏FS值为(40.64±25.45)k Pa,肝脏FS值为(20.76±13.21)k Pa,脾脏FS值与肝脏FS值呈正相关(r=0.402,P0.001)。无EV患者的脾脏FS值较伴轻度以及中-重度EV患者的显著下降(均P0.05),且轻度EV组较中-重度EV组的显著下降(P0.05)。脾脏FS值预测EV的AUROC为0.863,灵敏度为79.4%,特异度为83.2%,预测中-重度EV的AUROC为0.924,灵敏度为87.9%,特异度为91.3%,均较肝脏FS值明显升高。结论:脾脏FS值可作为预测接受抗病毒治疗乙肝肝硬化患者EV及其程度的无创性指标。
[Abstract]:Objective: To investigate the diagnostic value of Fibro Scan (FS) for the detection of spleen hardness in patients with hepatitis B cirrhosis (esophageal varices, EV) with antiviral therapy. Methods: 41 cases of hepatitis B cirrhosis patients received antiviral treatment in the clinic or in hospital of our hospital in 1-12 months of 2014 were included in this study. The value of spleen and liver elasticity was measured with FS, and gastroscopy was performed at the same time. The area under the working characteristic curve (area under receiver operating characteristic curve, AUROC) was calculated by the results of gastroscopy for the spleen FS value and FS value of the liver (area under receiver operating characteristic curve, AUROC), and the predictive value of the spleen to EV and its degree was evaluated. Results: the spleen FS value was (40.64 + 25). .45) k Pa, the liver FS value was (20.76 + 13.21) k Pa, the spleen FS value was positively correlated with the liver FS value (r=0.402, P0.001). No EV patient's splenic FS value was lower than that of mild and moderate severe patients. The degree was 83.2%, the AUROC of moderate to severe EV was 0.924, the sensitivity was 87.9%, the specificity was 91.3%, which was significantly higher than that of the liver FS. Conclusion: the spleen FS value can be used as a noninvasive index to predict the EV and its degree of hepatitis B patients receiving HBV treatment.

【作者单位】：广州市第八人民医院肝病科;
【基金】：广东省科技厅科技计划项目
【分类号】：R575.2

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