摘要
目的探讨肝硬度(LS)、谷草转氨酶/血小板比值指数(APRI)、肝纤维化指数4(FIB-4)、及白蛋白-胆红素评分(ALBI)与肝静脉压力梯度(HVPG)之间的相关性,并分析以上指标对门静脉高压食管胃静脉曲张破裂出血的诊断价值。方法选择2018年11月至2020年5月于十堰市太和医院感染科住院并行HVPG测定的肝硬化患者62例,根据患者住院期间的检查结果及FibroScan测得的LS计算FIB-4、ALBI及APRI。使用Spearman秩相关分析LS、ALBI、FIB-4、APRI与HVPG之间的相关性。绘制受试者工作特征曲线(ROC曲线),计算ROC曲线下面积(AUC),评价各无创指标对门静脉高压出血风险的预测价值。结果相关性分析结果显示,LS、ALBI、FIB-4、APRI与HVPG均呈正相关(r=0.613、0.578、0.539、0.485,P<0.001)。LS、ALBI、FIB-4、APRI单独应用诊断HVPG≥12 mmHg的AUC分别为0.883、0.842、0.812、0.799,相应的截断值分别为24.50、-1.92、3.94、0.80,其中FIB-4的敏感度为84.09%,特异度为83.33%。结论 LS、ALBI、FIB-4、APRI与HVPG均有较好的相关性,对门静脉高压均有一定的诊断价值,其中FIB-4在预测肝硬化患者食管胃静脉曲张出血风险上有较好的预测价值。
Objective To explore the correlation among liver stiffness(LS),albumin-bilirubin score(ALBI),fibrosis index based on the 4 fator(FIB-4),aspartate aminotransferase/platelets ratio index(APRI)and hepatic venous pressure gradient(HVPG),and analyze the diagnostic value of the above indexes for esophagogastric variceal bleeding in portal hypertension.Methods Sixty-two patients with cirrhosis who were detected by HVPG in infection department of Taihe Hospital from November 2018 to May 2020 were selected,and calculated FIB-4,ALBI and APRI based on the results of the patient’s inpatient visit and the LS measured by FibroScan.The correlation among LS,ALBI,FIB-4,APRI and HVPG were analyzed using Spearman rank correlation.The working characteristic curve(ROC curve)of the subjects was drawn,and the area under the ROC curve(AUC)was calculated to evaluate the predicted value of various noninvasive indexs for the risk of hypertension bleeding in the door veins.Results Correlation analysis showed positive correlations among LS,ALBI,FIB-4,APRI and HVPG(r=0.613,0.578,0.539,0.485,P<0.001).The AUC of HVPG≥12 mmHg diagnosticed by LS,ALBI,FIB-4,APRI alone were 0.883,0.842,0.812,0.799,and the corresponding cutoff values were 24.50,-1.92,3.94,and 0.80,respectively.Among them,the sensitivity of FIB-4 was 84.09%and the specificity was 83.33%.Conclusion LS,ALBI,FIB-4,APRI and HVPG all have good correlation,and have certain diagnostic value for gate vein hypertension.Among them,FIB-4 has good predictive value in predicting the risk of esophagogastric variceal bleeding in patients with cirrhosis.
作者
何雨倩
马德强
曾伊凡
王传敏
陈悦
HE Yuqian;MA Deqiang;ZENG Yifan;WANG Chuanmin;CHEN Yue(Department of Infectious Diseases,Taihe Hosipital of Shiyan City,Shiyan 442000,China)
出处
《河南医学研究》
CAS
2021年第18期3315-3319,共5页
Henan Medical Research
基金
中国肝炎防治基金会王宝恩肝纤维化研究基金项目(2021033)。
关键词
肝硬度
肝硬化
肝静脉压力梯度
食管和胃静脉曲张
liver stiffness
liver cirrhosis
hepatic venous pressure gradient
esophageal and gastric varices
作者简介
通信作者:陈悦,E-mail:Cyue63@126.com。
