瞬时弹性扫描仪检测肝脏硬度评估肝硬化门静脉高压症  

Liver stiffness measured by FibroScan for evaluating portal hypertension in patients with liver cirrhosis

作　　者：陈志敏[1] 应若素[1] 陈铿[1] 刘惠媛[1] 

机构地区：[1]广州市第八人民医院肝病三科,510000

出　　处：《中华生物医学工程杂志》2016年第2期131-134,共4页Chinese Journal of Biomedical Engineering

摘　　要：目的：应用瞬时弹性扫描仪（FibroScan）检测肝脏硬度，并探讨其与肝硬化患者门静脉高压症相关指标的关系。方法收集2013年4月至2014年4月广州市第八人民医院肝病科住院治疗的肝硬化患者136例，所有患者应用FibroScan测量肝脏硬度（FS值），同期行胃镜、腹部超声及外周血血小板计数检测。将患者按食管或胃底静脉曲张的严重程度分组，进行FS值的组间比较。分析FS值与食管、胃底静脉曲张程度，门静脉宽度，脾脏厚度，脾静脉宽度和血小板计数的相关性。结果所有肝硬化患者按食管静脉曲张严重程度分为无食管静脉曲张组（n=42）、轻度食管静脉曲张组（n=30）、中度食管静脉曲张组（n=26）和重度食管静脉曲张组（n=38），其FS值分别为（17.74±15.91）kPa、（22.81±13.76）kPa、（27.36±11.10）kPa、（40.11±21.37）kPa。所有肝硬化患者按胃底静脉曲张严重程度分为无胃底静脉曲张组（n=55）、轻度胃底静脉曲张组（n=29）、中度胃底静脉曲张组（n=24）和重度胃底静脉曲张组（n=28），其FS值分别为（22.80±15.91）kPa、（25.95±5.93）kPa、（33.73±13.45）kPa、（42.53±18.87）kPa。肝脏FS值随食管、胃底静脉曲张程度的加重而呈上升趋势。组内比较显示，与中度、重度食管、胃底静脉曲张组比较，无食管、胃底静脉曲张组及轻度食管、胃底静脉曲张组患者肝脏FS值均显著降低（均P＜0.05）。肝脏FS值与食管、胃底静脉曲张程度，门静脉宽度，脾脏厚度，脾静脉宽度呈正相关（rs=0.506、0.461、0.152、0.275、0.284，均P＜0.05），与血小板计数呈负相关（rs=-0.181，P＜0.05）。结论应用FibroScan检测肝脏硬度与门静脉高压症相关指标有较好的相关性，是一种评估肝硬化患者门静脉高压症严重程度的有效的非侵入性检查方法。Objective To measure the liver stiffness by using FibroScan,and to investigate the associations between liver stiffness and the indicators of portal hypertension in patients with liver cirrhosis. Methods One hundred and thirty？six patients with liver cirrhosis treated in Department of Hepatology, Guangzhou No.8 People＆#39;s Hospital between April 2013 and April 2014 were included in this study. All the patients were measured for liver stiffness （FS values） with FibroScan, and meanwhile underwent gastroscopy,abdominal ultrasonography and peripheral blood platelet counting. The patients were divided into different groups based on the severity of esophageal or gastric varices,and the FS values were compared among the groups. The correlations of FS values with esophageal or gastric varices,portal vein width, thickness of spleen,splenic vein width and platelet counts were analyzed. Results According to the severity of esophageal varices,all cirrhotic patients were divided into non？（n=42）,mild（n=30）,moderate（n=26） and severe esophageal varices（n=38）groups,with FS values being（17.74 ± 15.91）kPa,（22.81 ± 13.76） kPa,（27.36 ± 11.10） kPa,and （40.11 ± 21.37） kPa,respectively. According to the severity of gastric＆amp;nbsp;varices,all cirrhotic patients were divided into non？（n=55）,mild（n=29）,moderate（n=24）and severe gastric varices （n=28） groups,with FS values being （22.80±15.91） kPa,（25.95 ± 5.93） kPa,（33.73 ± 13.45）kPa,and（42.53±18.87）kPa,respectively. The liver FS values showed an increasing trend along with more severe esophageal or gastric varices. Within？group comparison showed that ,the liver FS values in patients with non？ or mild esophageal/gastric varices were significantly lower than those in patients with moderate or severe esophageal/gastric varices （all P〈0.05）. The liver FS value was positively correlated with severity of esophageal/gastric varices,portal vein width,thickness of spleen,and splenic vein width （rs=0.

关 键 词：肝硬化 高血压 门静脉 瞬时弹性扫描仪 

分 类 号：R575.2[医药卫生—消化系统]