| 摘要: |
| 目的 本研究应用声辐射力脉冲成像(Acoustic Radiation Force Impulse ARFI)技术对慢性乙型肝炎肝硬化患者进行脾脏弹性检测和分析,探讨和对比脾脏ARFI弹性及脾脏ARFI弹性联合血小板计数(Platelet Count PC)在预测乙肝肝硬化食道静脉曲张的临床应用价值。方法 对232例慢性乙型肝炎肝硬化患者应用ARFI技术检测脾脏实时超声弹性,并测量PC,所有患者均于检测前后一周内行胃镜检查明确食管静脉曲张情况,以胃镜结果为金标准,应用受试者工作特征(receiver operating characteristic, ROC)曲线比较脾脏ARFI弹性、PC、及脾ARFI弹性联合PC诊断肝硬化食管静脉曲张的临床价值。结果 食道静脉曲张组脾脏ARFI弹性和PC分别为3.52(3.16-3.87)m/s 和62(41-88.25),无食道静脉曲张组脾脏ARFI弹性和PC分别为2.91(2.35-3.35)m/s和129.5(87.25-196.25)。脾脏ARFI弹性和PC在两组间比较的差异均具有统计学意义(P＜0.001 )。单独脾脏ARFI弹性及脾脏ARFI弹性联合PC的ROC曲线下面积分别为0.76和0.83,差异具有统计学意义(P = 0.0021)。结论 脾脏ARFI弹性测值联合PC较单纯脾脏ARFI弹性能更准确的无创预测慢性乙型肝炎肝硬化食管静脉曲张的存在,具有良好的临床应用前景。 |
| 关键词: 声辐射力脉冲成像 脾脏 血小板计数 肝硬化 食管静脉曲张 |
| DOI： |
| 投稿时间：2021-05-12修订日期：2021-12-07 |
| 基金项目:首都临床特色应用研究专项课题(编号：Z161100000516174) |
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| The clinical value of spleen stiffness by acoustic radiation force impulse imaging elastography combined with platelet count for predicting esophageal varices in hepatitis B-related cirrhosisZhang Da-kun, Chen min, Shi Xiao-juan, Wang Rui-fang, |
| zhang dakun,chen min,shi xiaojuan,wang ruifang |
| () |
| Abstract: |
| Objective To investigate the diagnostic value of the spleen stiffness using Acoustic Radiation Force Impulse (ARFI) elatography combined platelet count (PC) in predicting the presence of esophageal varices in patients with hepatitis B virus-related cirrhosis.
Methods 232 patients with hepatitis B virus-related cirrhosis were included, the subjects were underwent endoscopy, liver function, blood count, as well as spleen stiffness by ARFI elatography using a ultrasonic instrument named ACUSON S2000. ARFI elatography of spleen was performed in all patients. The patients were divided into no espophageal varices group and esophageal varices group, and the difference between the two groups was compared. Referring to the endoscopy, the spleen stiffness and the platelet count value were assessed by using Receiver Operating Characteristic (ROC) curve analysis. The corresponding cut-off values, sensitivity and specificity were also calculated and compared. Results The mean values of ARFI of spleen were 3.52 (3.16-3.87) m/s and 2.91 (2.35-3.35) m/s in patients with esophageal varices group and without esophageal varices group(P＜0.01). The mean values of PC were 62 (41-88.25) and 129.5 (87.25-196.25) 109/L in patients with esophageal varices group and without esophageal varices group (P＜0.001). Accordingly, the areas under the ROC curves (AUROC) for ARFI of spleen, ARFI of spleen combined platelet count were 0.76 and 0.83 for predicting esophageal varices in patients with hepatitis B virus-related cirrhosis (P = 0.0021), respectively. Conclusions ARFI of spleen combined with PC can improve the diagnostic performance for predicting the presence of esophageal varices in hepatitis B-related cirrhosis. |
| Key words: Acoustic radiation force impulse Spleen Platelet Count Hepatic cirrhosis Esophageal varices |
