摘要
目的探讨瞬时弹性成像技术(Fibro Scan)、天冬氨酸氨基转移酶和血小板比率指数(aspartate aminotransferase-to-platelet ratio index,APRI)及其二者联合检测肝硬化患者合并食管胃底静脉曲张破裂出血风险的相关性和诊断预测价值.方法将210例病毒性肝炎肝炎后肝硬化患者根据2015年《肝硬化门静脉高压食管胃静脉曲张出血的防治指南》分为无、有出血组,分别为153、57例;搜集患者在1 wk内的Fibro Scan值[肝脏硬度值(liver stiffness measurement,L S M)]和A P R I值.组间比较采用t检验,利用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析LSM、APRI、LSM+APRI对肝硬化患者出血风险的预测价值,并比较LSM、APRI及LSM+APRI的ROC曲线下面积(area under curve,AUC).结果有、无出血组的LSM值分别是28.49 k Pa±9.46 k Pa,22.87 k Pa±6.95 k Pa,APRI值分别是2.99±1.11,2.13±1.01,有明显的统计学意义.有无出血风险的LSM、APRI、LSM+APRI的AUC分别是0.669、0.727、0.722,表明APRI、LSM+APRI对食管胃底静脉曲张破裂出血具有良好的诊断效果.结论APRI及Fibro Scan联合APRI对肝硬化患者合并食管胃底静脉曲张破裂出血风险存在有效的预测价值.
AIM To investigate the value of FibroScan and aspartate aminotransferase-to-platelet ratio index （APRI）, alone or in combination, in predicting the risk of esophagogastric variceal bleeding in patients with liver cirrhosis.METHODS Two hundred and ten patients with posthepatitic cirrhosis were divided into a non-bleeding group （n= 153） and a bleeding group （n = 57） according to the presence of esophagogastric variceal bleeding or not. FibroScan values （LSM values） and APRI values were obtained within a week and compared between the two groups using t-tests. Receiver operating characteristic curve （ROC） analysis was used to assess the accuracy of LSM alone, APRI alone, and LSM ＋ APRI in predicting the risk of esophagogastric variceal bleeding.RESULTS The LSM values of the patients with and without bleeding were 28.49 kPa ± 9.46 kPa and 22.87 kPa ± 6.95 kPa, respectively, and the APRI values were 2.99 ± 1.11 and 2.13 ±1.01, respectively, both of which showed a significant difference between the two groups. The AUCs of LSM alone, APRI alone, and LSM ＋ APRI in predicting the risk of bleeding were 0.669, 0.727 and 0.722, respectively, suggesting that APRI alone and LSM ＋ APRI had good diagnostic value in esophagogastric variceal bleeding.CONCLUSION APRI alone and FibroScan combined with APRI have good predictive value for the risk of esophageal variceal bleeding in patients with liver cirrhosis.
出处
《世界华人消化杂志》
CAS
2017年第14期1287-1291,共5页
World Chinese Journal of Digestology
基金
2016年洛阳市科技计划基金资助项目
No.1603003A-6
河南省中青年卫生科技创新人才基金资助项目~~
