基于2D-SWE联合APRI建立无创模型对门静脉高压检测的评估价值研究  

Study on the evaluation value of a non-invasive model based on 2D-SWE combined with APRI in detecting portal hypertension

作　　者：宦徽 刘超 胡丽霞 魏清 涂庆丽 任涛 HUAN Hui;LIU Chao;HU Lixia(Chengdu Office Hospital of the People’s Government of Tibet Autonomous,Sichuan,Chengdu 610000,China)

机构地区：[1]西藏自治区人民政府驻成都办事处医院,成都市610000

出　　处：《河北医药》2023年第17期2576-2579,共4页Hebei Medical Journal

基　　金：西藏自治区自然科学基金(编号:XZ202001ZR0073G);成都市医学科研课题(编号:2021323);西藏自治区人民政府驻成都办事处医院院级课题(编号:2020YJYB-5、2021-YJ-11)。

摘　　要：目的基于二维超声弹性成像技术(2D-SWE)联合APRI建立无创模型对门静脉高压检测价值进行评价,为无创检测门静脉高压提供借鉴。方法选择2019年2月至2022年1月收治的门静脉高压患者63例,依据肝静脉压力梯度(HVPG)的出血风险程度分为低危组(<12 mm Hg)20例和高危组(≥12 mm Hg)43例。测定天冬氨酸氨基转移酶(AST)、血小板(PLT)、测量肝静脉压力梯度(HVPG)。通过2D-SWE检测肝硬度,建立2D-SWE联合APRI无创模型,分析检测效能。结果2D-SWE、APRI单独对HVPG均有较好的诊断效能,其中2D-SWE曲线下面积为0.785[95%CI(0.671~0.899)],灵敏度0.558,特异度0.90,最佳截断值为18.80 kPa。APRI曲线下面积为0.786[95%CI(0.669~0.903)],灵敏度0.674,特异度0.80,最佳截断值为0.7712。2D-SWE联合APRI构建联合模型的曲线下面积为0.819[95%CI(0.711~0.927)],灵敏度0.628,特异度0.90,优于单独模型。结论2D-SWE、APRI及2D-SWE-APRI联合模型对于门静脉高压均有一定评估的价值,联合模型效能更优,可为无创检测门静脉高压提供借鉴。Objective To analyze the evaluation value of a non-invasive model based on two-dimensional shear wave elastography(2D-SWE)combined with aspartate aminotransferase-to-platelet ratio index(APRI)in detecting portal hypertension,thus providing references for the non-invasive detection of portal hypertension.Methods A total of 63 patients with portal hypertension admitted to our hospital from February 2019 to January 2022 were selected as the research subjects.According to hepatic venous pressure gradient(HVPG),twenty cases were included into low-risk group(HVPG<12mmHg),and 43 cases were included into high-risk group(HVPG≥12mmHg).Aspartate aminotransferase(AST),platelet count(PLT),and HVPG were measured.Liver stiffness was detected by 2D-SWE.A non-invasive model based on 2D-SWE combined with APRI was established,and its detection efficiency was analyzed.Results Either 2D-SWE or APRI alone had a good diagnostic performance for HVPG.The area under the curve(AUC),sensitivity,specificity and the cut-off value of 2D-SWE in diagnosing portal hypertension were 0.785(95%CI:0.671~0.899),0.558,0.90,and 18.80kPa,respectively.The AUC,sensitivity,specificity and the cut-off value of APRI in diagnosing portal hypertension were 0.786(95%CI:0.669~0.903),0.674,0.80,and 0.7712,respectively.The AUC,sensitivity,and specificity of 2D-SWE combined with APRI in diagnosing portal hypertension were 0.819(95%CI:0.711~0.927),0.628,and 0.90,respectively,the diagnostic performance of which was better than that of a single detection.Conclusion 2D-SWE,APRI and their combination all have certain evaluation value in detecting portal hypertension,and the combined model has a better efficiency,which can provide reference for non-invasive detection of portal hypertension.

关 键 词：二维超声弹性成像技术 APRI 无创诊断模型 门静脉高压 

分 类 号：R445.1[医药卫生—影像医学与核医学]