超声造影联合血清学指标评估失代偿期肝硬化患者门静脉高压的临床价值

发布时间：2019-06-17 14:53

【摘要】：目的探讨超声造影联合常规血清学标志物评估失代偿期肝硬化患者门静脉高压的可行性。方法根据肝静脉压力梯度(hepatic venous pressure gradient,HVPG)将54例失代偿期肝硬化门静脉高压患者分为HVPG12 mmHg(1 mmHg=0.133 kPa)和HVPG≥12 mmHg两组。对血常规、肝功能、出凝血功能、Childpugh评分(Child-pugh score,CPS)及肝脏超声造影定量参数,包括肝动脉到达时间(hepatic artery arrival time,HAAT)、肝静脉到达时间(hepatic vein arrival time,HVAT)、门静脉到达时间(portal vein arrival time,PVAT)、肝动脉-肝静脉渡越时间(hepatic artery to hepatic vein arrive transmit time,HA-HVTT)、门静脉-肝静脉渡越时间(portal vein to hepatic vein arrive transmit time,PV-HVTT),进行单因素分析和Logistic回归分析,筛选出可以诊断门静脉高压的无创指标,并在此基础上构建诊断模型。通过ROC曲线评价模型的诊断价值并确定界值。结果建立诊断模型Y=-0.217×PV-HVTT+1.526×CPS-7.097。当模型的预测概率值≥0.631时,其判断HVPG≥12 mmHg的敏感性为87.5%,特异性为78.6%,ROC曲线下面积为0.857。结论由PV-HVTT和CPS建立的无创诊断模型对评估门静脉高压有一定的临床价值。
[Abstract]:Objective to investigate the feasibility of contrast-enhanced ultrasound combined with routine serological markers in evaluating portal hypertension in patients with decompensated liver cirrhosis. Methods according to hepatic venous pressure gradient (hepatic venous pressure gradient,HVPG), 54 patients with decompensated cirrhotic portal hypertension were divided into HVPG12 mmHg (1 mmHg=0.133 kPa) and HVPG 鈮，

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