摘要
目的探讨瞬时弹性成像技术检查脾硬度与肝硬化患者食管胃底静脉曲张程度的相关性。方法从吉林大学第二医院2012年12月-2013年12月收治的肝硬化患者中选择拟行胃镜检查的72例进行研究,利用瞬时弹性扫描仪对患者的脾脏及肝脏硬度值进行检测,并进行胃镜检查。计数资料组间比较采用χ2检验,计量资料组间比较采用t检验,食管静脉曲张程度与脾脏硬度的相关性采用Pearson相关分析。结果随Child-Pugh分级的增加,患者的肝脏和脾脏硬度值呈不断上升的趋势。肝硬化患者的脾脏硬度值与肝脏硬度值之间呈正相关(r=0.367,P<0.05)。Child-Pugh A、B、C级患者的脾脏硬度值两两间比较差异均有统计学意义(t值分别为5.149、7.231、6.119,P值分别为0.031、0.025、0.037);中度和重度食管胃底静脉曲张患者的脾脏和肝脏硬度值均出现明显增高的情况,经受试者工作特征(ROC)曲线分析,脾脏硬度值的ROC曲线下面积(AUC)、灵敏度、特异度均显著高于肝脏硬度值和PLT/脾厚度值。结论利用瞬时弹性扫描仪进行脾硬度检测与肝硬化患者的食管胃底静脉的曲张程度具有很好的相关性,且安全无创,特别适用于不适合胃镜检查的肝硬化患者。
Objective To explore the correlation of spleen stiffness measured by Fibro Scan with esophageal and gastric varices in patients with liver cirrhosis. Methods Spleen and liver stiffness was measured by Fibro Scan in 72 patients with liver cirrhosis who received gastroscopy in our hospital from December 2012 to December 2013. Categorical data were analyzed by χ2test,and continuous data were analyzed by t test. Pearson’s correlation analysis was used to investigate the correlation between the degree of esophageal varices and spleen stiffness. Results With the increase in the Child- Pugh score in patients,the measurements of liver and spleen stiffness showed a rising trend. Correlation was found between the measurements of spleen and liver stiffness( r = 0. 367,P 〈 0. 05). The differences in measurements of spleen stiffness between patients with Child- Pugh classes A,B,and C were all significant( t = 5. 149,7. 231,and 6. 119,respectively; P =0. 031,0. 025,and 0. 037,respectively). The measurements of spleen and liver stiffness showed marked increases in patients with moderate and severe esophageal and gastric varices. The receiver operating characteristic( ROC) curve analysis showed that the area under the ROC curve,sensitivity,and specificity for spleen stiffness were significantly higher than those for liver stiffness and platelet count / spleen thickness. Conclusion The spleen stiffness measurement by Fibro Scan shows a good correlation with the esophageal and gastric varices in patients with liver cirrhosis. Fibro Scan is safe and noninvasive,and especially useful for those who are not suitable for gastroscopy.
出处
《临床肝胆病杂志》
CAS
2015年第3期374-377,共4页
Journal of Clinical Hepatology
关键词
肝硬化
食管和胃底静脉曲张
脾
弹性成像技术
诊断
liver cirrhosis
esophageal and gastric varices
spleen
elasticity imagine technigues
diagnose