CT门静脉成像联合肝功能指标对肝硬化胃底食管静脉曲张出血风险的预测  

CT portal vein imaging combined with liver function indexes to predict the risk of bleeding from gastric fundus esophageal varices in liver cirrhosis

作　　者：李猛[1] 陈亚明[1] 赵本好 胡波 胡燕 Li Meng;Chen Yaming;Zhao Benhao;Hu Bo;Hu Yan(Department of Radiology,Wanbei Coal-Electricity Group General Hospital,Suzhou 234000,China)

机构地区：[1]皖北煤电集团总医院放射科,宿州234000

出　　处：《中国医师进修杂志》2022年第12期1101-1104,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨CT门静脉成像联合肝功能指标预测肝硬化胃底食管静脉曲张出血风险的价值。方法选取皖北煤电集团总医院82例肝硬化合并胃底食管静脉曲张患者,根据入院后6周内是否发生胃底食管静脉曲张出血分为出血组(24例)和未出血组(58例)。比较两组一般资料、入院时CT门静脉成像参数门静脉主干(MPV)、脾静脉(SPV)、胃左静脉(LGV)直径及血清肝功能指标丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)水平,分析CT门静脉成像参数联合血清肝功能指标预测胃底食管静脉曲张出血风险的价值。结果出血组年龄和MPV、SPV、LGV直径高于未出血组[(55.17±12.02)岁比(53.71±10.48)岁、(18.05±2.74)mm比(15.22±2.18)mm、(13.68±1.35)mm比(12.26±1.43)mm、(6.82±1.38)mm比(5.30±0.94)mm],血清ALT、AST、TBIL水平低于未出血组[(23.71±5.74)U/L比(34.95±8.26)U/L、(27.65±6.61)U/L比(39.29±10.24)U/L、(17.20±5.49)U/L比(26.13±7.85)U/L],差异均有统计学意义(P<0.05)。绘制受试者工作特征曲线,结果显示CT门静脉成像参数联合肝功能指标预测的曲线下面积最大,为0.889(95%CI 0.812~0.967),灵敏度、特异度分别为83.34%、81.03%。结论CT门静脉成像联合肝功能指标在预测肝硬化胃底食管静脉曲张出血风险方面具有良好价值。Objective To explore the value of CT portal vein imaging combined with liver function indexes in predicting the risk of esophageal variceal bleeding in patients with liver cirrhosis.Methods A total of 82 patients with liver cirrhosis complicated with gastric fundus esophageal varices in Wanbei Coal-Electricity Group General Hospital were selected and divided into bleeding group(24 cases)and non-bleeding group(58 cases)according to the occurrence of gastric fundus esophageal varices bleeding within 6 weeks after admission.General data of the two groups,CT portal vein imaging parameters at admission including diameter of main portal vein(MPV),diameter of splenic vein(SPV),diameter of left gastric vein(LGV),serum liver function indexes including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)levels were compared between the two groups,and analyzed the value of CT portal vein imaging parameters and serum liver function indexes levels in predicting the risk of gastric fundus esophageal varices bleeding.Results The age and diameter of MPV,SPV,LGV in bleeding group were higher than those in the non-bleeding group:(55.17±12.02)years vs.(53.71±10.48)years,(18.05±2.74)mm vs.(15.22±2.18)mm,(13.68±1.35)mm vs.(12.26±1.43)mm,(6.82±1.38)mm vs.(5.30±0.94)mm;the levels of serum ALT,AST,TBIL in bleeding group were lower than those in the non-bleeding group:(23.71±5.74)U/L vs.(34.95±8.26)U/L,(27.65±6.61)U/L vs.(39.29±10.24)U/L,(17.20±5.49)U/L vs.(26.13±7.85)U/L,there were statistical differences(P<0.05).The results of receiver operating characteristic curve showed that the area under the curve(AUC)of combined index to predict gastric fundus esophageal varices bleeding was 0.889(95%CI 0.812-0.967),and the sensitivity and specificity were 83.34%and 81.03%,respectively.Conclusions CT portal vein imaging combined with liver function indexes has a good value in predicting the risk of gastric fundus esophageal varices bleeding in liver cirrhosis.

关 键 词：肝硬化 食管和胃静脉曲张 出血 肝功能试验 CT门静脉成像 

分 类 号：R575.2[医药卫生—消化系统] R816.5[医药卫生—内科学]