瞬时弹性成像和超声检查对乙肝肝硬化患者食管静脉曲张程度的评估价值  

Evaluation of Esophageal Varices in Patients with Hepatitis B Cirrhosis by Transient Elastography and Ultrasonography

作　　者：朱敏嘉 钱杰 杨璐璇 施海群 Zhu Minjia;Qian Jie;Yang Luxuan;Shi Haiqun(Department of Ultrasound,The Fifth People's Hospital of Suzhou,Suzhou,Jiangsu 215131)

机构地区：[1]苏州市第五人民医院超声科,江苏苏州215131

出　　处：《现代医用影像学》2021年第10期1943-1946,共4页Modern Medical Imageology

摘　　要：目的:通过瞬时弹性成像FibroScan检测肝硬度值和腹部超声测量脾静脉内径及脾脏厚度评估乙肝肝硬化患者食管静脉曲张程度的临床应用价值。方法:回顾性分析2019年1月-2021年4月在苏州市第五人民医院收治的均成功行瞬时弹性成像检测肝硬度值和成功行电子胃镜检查的乙肝肝硬化患者35例。以电子胃镜检查为金标准,将食管静脉曲张分为无曲张组、轻度曲张组、中度曲张组和重度曲张组;以肝功能分级为标准,分为Child-Pugh A级、B级和C级。所有患者均行腹部超声测量脾静脉内径及脾脏厚度。分别比较不同组别食管静脉曲张患者的肝硬度值、脾静脉内径及脾脏厚度;分别比较不同Child-Pugh分级患者肝硬度值。结果:不同组别食管静脉曲张患者的肝硬度值随着静脉曲张严重程度的加重而加重,具有明显的差异性,其中无曲张组的肝硬度值均小于曲张组,轻度曲张组的肝硬度值均小于中度和重度曲张组;中度曲张组的肝硬度值均小于重度曲张组,具有统计学意义。轻度曲张组、中度曲张组和重度曲张组的脾静脉内径及脾脏厚度均随食管静脉曲张破裂出血风险的增加而增加,具有明显的差异性。Child-Pugh A级和B级患者的肝硬度值比C级患者的肝硬度值低,A级患者的肝硬度值比B级患者的肝硬度值低,具有明显的差异性。结论:瞬时弹性成像和超声检查均能准确评估乙肝肝硬化患者食管静脉曲张程度,对患者食管静脉破裂出血的风险有预判作用。Objective:To evaluate the clinical application value of esophageal varices in patients with hepatitis B cirrhosis by transient elastography FibroScan detection of liver hardness value and abdominal ultrasound measurement of splenic vein diameter and spleen thickness.Methods:A retrospective analysis was performed on 35 patients with hepatitis B cirrhosis who were admitted to The Fifth People’s Hospital of Suzhou from January 2019 to April 2021 and underwent transient elastography to detect liver hardness and electronic gastroscopy. Using electronic gastroscopy as the gold standard, esophageal varices were divided into non-varicose group, mild varicose group, moderate varicose group and severe varicose group. Based on liver function grading, they were divided into Child-Pugh grade A, B and C. Spleen vein diameter and spleen thickness were measured by abdominal ultrasound in all patients. The liver hardness, splenic vein diameter and spleen thickness of esophageal varices in different groups were compared. Liver hardness values of different Child-Pugh grading patients were compared.Results:The liver hardness values of different groups of esophageal varices increased with the severity of varices, with significant difference. The liver hardness values of the non-varices group were all lower than the varices group, and the liver hardness values of the mild varices group were all lower than the moderate and severe varices groups. The liver hardness values of moderate variceal group were all lower than those of severe variceal group, with statistical significance. The splenic vein diameter and spleen thickness of the mild, moderate and severe varices groups increased with the increase of the risk of esophageal variceal rupture and bleeding, with significant differences. The liver hardness values of Child-Pugh grade A and B patients were lower than that of grade C patients, while the liver hardness values of grade A patients were lower than that of grade B patients, showing obvious differences.Conclusion:Transient elast

关 键 词：瞬时弹性成像 超声检查 乙肝 食管静脉曲张 

分 类 号：R575.2[医药卫生—消化系统] R512.62[医药卫生—内科学] R445.1[医药卫生—临床医学]