Fibroscan联合APRI在肝硬化门脉高压性胃病中的应用价值  

Application Value of Fibroscan Combined with APRI in the Diagnosis of Cirrhosis Portal Hypertensive Gastropathy

作　　者：赵智[1] 章保新[1] 刘小利[1] 

机构地区：[1]武警湖南总队医院消化内科,湖南长沙410006

出　　处：《医学临床研究》2016年第10期1952-1955,共4页Journal of Clinical Research

摘　　要：[目的]探讨瞬时弹性扫描仪（Fibroscan）和谷草转氨酶-血小板指数比值（APRI）与肝硬化门脉高压性胃病（PHG）的关系，分析两种方法联合检测诊断PHG的临床意义。[方法]检测116例乙型病毒性肝硬化患者中肝脏组织硬度值（LSM）、APRI、食管静脉曲张程度（EV）、门静脉宽度（PVD）、血小板计数-脾长径比值（PC／SD）、PHG情况，分析LSM、APRI与EV、PVD、PC／SD之间的关系，并比较不同程度PHG患者LSM、APRI的差异，随后绘制LSM、APRI诊断PHG的ROC曲线。[结果]不同程度EV中LSM、APRI比较差异有统计学意义，LSM、APRI与PVD、PC／SD相关，不同程度PHG患者LSM、APRI之间的差异有统计学意义。FibroScan诊断PHG的受试者工作曲线下面积（AUROE）为0．80（0．71～0．89），敏感度为78．91％，特异性为73．08％，APRI诊断PHG的AUROC为0．80（0．70～0．90），敏感度为65．83％，特异性为92．27％，FibroSean联合APRI诊断PHG的AUROC为0．95（0．89～1．00），敏感度为86．77％，特异性为98．10％。[结论]FibmScan和APRI能反映肝硬化患者的门静脉压力及PHG情况，两种方法联合检测更有助于提高诊断的精确性，对PHG无创诊断具有一定的临床价值。[Objective]To study the relationship between Fibroscan, aspartate aminotransferase to platelet ratio index （APRI）, and cirrhosis portal hypertensive gastropathy （PHG） and analyze the clinical significance of combined detection of the two methods in the diagnosis of PHG. [Methods]A total of 116 cases of hepatitis B infection-related liver cirrhosis were detected for liver stiffness measurement （LSM）, APRI, degree of esophageal varices （EV）, portal vein diameter （PVD）, platelet count/spleen diameter （PC/SD）, and PHG. The relationships between LSM, APRI and EV, PVD, and PC/SD were analyzed and the differences of LSM and APRI were compared in varying degrees of PHG patients. Then, the receiver operating characteristic curves （ROC） of LSM and APRI were drawn to diagnose PHG. [Results]The differences were statistically significant for LSM and APRI in varying degrees of EV. LSM and APRI have correlation with PVD and PC/SD. Also, LSM and APRI in patients with varying degrees of P HG were statistically significant. AUROC of Fibroscan for P HG was 0.80 （0.71-0.89, the sensitivity was 78.91%, and the specificity was 73.08%. The AUROC of APRI for PHG was 0.80（0.70-0.90）, the sensitivity was 65.83% ,and the specificity was 92.27%. The AUROC of the combined method for PHG was 0.95 （0.89 - 1.00）, the sensitivity was 86.770%, and the specificity was 98.10 %. [ Conclusion] FibroScan and APRI reflected the degree of portal hypertension and PHG in liver cirrhosis patients. The combined detection of the two methods was more helpful to improve the accuracy of diagnosis, and it had certain clinical value for the noninvasive diagnosis of PHG.

关 键 词：弹性成像技术 天冬氨酸氨基转移酶类 肝硬化/并发症 高血压 门静脉/病因学 胃病/病因学 

分 类 号：R573[医药卫生—消化系统]