血清ALT、AST联合NFS评分对非酒精性脂肪性肝硬化患者食管胃底静脉曲张严重程度的评估价值  

Value of Serum ALT,AST Combined with NFS Score in Evaluating the Severity of Esophagogastric Varices in Cirrhosis

作　　者：姜炅[1] 袁佳[1] 史海涛[1] 戴社教[1] JIANG Wei;YUAN Jia;SHI Hai-tao;DAI She-jiao(Department of Gastroenterology,Second Affiliated Hospital of Xi'an Jiaotong University(Xi'an,Shaanxi,710004)China)

机构地区：[1]西安交通大学第二附属医院消化内科,陕西西安710004

出　　处：《中西医结合肝病杂志》2020年第4期314-317,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:探讨血清中谷丙转氨酶(ALT)、谷草转氨酶(AST)联合非酒精性脂肪性肝纤维化评分(NFS)对非酒精性脂肪性肝硬化患者食管胃底静脉曲张(EGV)严重程度的评估价值。方法:回顾性分析2016年7月至2018年9月收治的130例该类患者的临床资料,根据其是否合并EGV分为A组(肝硬化未合并EGV,n=65)与B组(肝硬化合并EGV,n=65),比较两组患者血清中ALT、AST水平及NFS评分,比较EGV严重程度不同的肝硬化患者血清ALT、AST水平及NFS评分,采用Pearson相关分析肝硬化合并EGV血清ALT、AST水平及NFS评分的相关性,采用多因素Logistic回归分析肝硬化食管胃底静脉曲张的影响因素,分析血清ALT、AST联合NFS评分对非酒精性脂肪性肝硬化患者食管胃底静脉曲张的诊断效能。结果:B组患者NFS评分显著高于A组(P<0.05);B组患者血清ALT、AST水平显著低于A组(P<0.05);EGV严重程度不同的患者血清ALT、AST水平及NFS评分差异有统计学意义(P<0.05);ALT与AST呈正相关(P<0.05),ALT与NFS呈负相关(P<0.05),AST与NFS呈负相关(P<0.05);ALT、AST、NFS为肝硬化EGV的独立危险因素(P<0.05);ALT、AST、NFS联合对该类肝硬化患者EGV的诊断效能明显优于各指标单项检测(P<0.05)。结论:血清ALT、AST联合NFS与肝硬化患者EGV严重程度密切相关,三者联合检测对EGV出血的预测具有重要指导意义,可在临床推广应用。Objective:To investigate the value of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST)and nonalcoholic fatty liver disease fibrosis score(NFS)in evaluating the severity of esophagogastric varices(EGV)in cirrhosis.Methods:The clinical data of 130 patients with cirrhosis admitted to our hospital from July 2016 to September 2018 were retrospectively analyzed.Patients were divided into two groups according to the absence and presence of the EGV,namely group A and group B,each with 65 cases.The serum levels of ALT,AST and NFS were compared between the two groups,which were also compared among patients with different severities of EGV.Pearson correlation analysis was used to analyze the correlation between serum ALT,AST levels and NFS score in patients with liver cirrhosis complicated with EGV.Multivariate logistic regression analysis was used to analyze the influencing factors of EGV in patients with liver cirrhosis.The diagnostic efficacy of serum ALT,AST combined with NFS score in patients with liver cirrhosis complicated with EGV was also analyzed.Results:The NFS score of group B was significantly higher than that of group A(P<0.05).The serum levels of ALT and AST in group B were significantly lower than those in group A(P<0.05).Serum ALT,AST levels and NFS scores were significantly different in cirrhosis patients with different severities of EGV(P<0.05).ALT was positively correlated with AST(P<0.05),and was negatively correlated with NFS score(P<0.05),meanwhile,AST was negatively correlated with NFS score(P<0.05).ALT,AST,and NFS scores were independent risk factors for EGV in cirrhosis(P<0.05).The diagnostic efficacy of combined detection of the three indicators in evaluating the EGV in cirrhosis was better than that of the single detection(P<0.05).Conclusion:Serum ALT,AST combined with NFS score are closely related to the severity of EGV in cirrhosis.The combined detection of three have important guiding significance for the prediction of esophageal varices bleeding,which can be promoted in cli

关 键 词：谷草转氨酶 谷丙转氨酶 非酒精性脂肪性肝纤维化评分 肝硬化食管胃底静脉曲张 评估价值 

分 类 号：R575.2[医药卫生—消化系统]