脾脏和肝脏硬度在预测食管静脉曲张中的作用。

Role of splenic and hepatic stiffness in predicting esophageal varices.

出版信息

Tunis Med. 2021;99(5):544-551.

DOI:

PMID:35244904

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8772598/

Abstract

INTRODUCTION

Non-invasive assessment of portal hypertension in chronic liver disease is a topical subject.

AIM

Evaluate accuracy of splenic (SS) and liver (LS) stiffness in predicting the presence of esophageal varices (OV) in chronic hepatitis B patients and determine a non-invasive composite score.

METHODS

This was a monocentric cross-sectional study, including carriers of chronic hepatitis B. All patients benefited of SS and LS measurement by impulse elastography (FibroScan Echosens), FIB-4 score calculation and oeso-gastro-duodenal endoscopy.

RESULTS

We included 84 patients. The average age was 49.04 ± 12.8 years. The mean value of SS and LS was significantly higher in presence of OV; p=0.000. At respective threshold values of 33.1 KPa and 43KPa, SS was able to predict the presence of OV and large OV with AUROC of 0.795 and 0.906. At respective threshold values of 7.75 KPa and 13.55 KPa, LS was able to predict the presence of OV and large OV with AUROC of 0.836 and 0.894. Arithmetic sum of SS, LS and FIB-4 values was able to predict the presence of OV and large OV with AUROC of 0.918 and 0.942.

CONCLUSION

SS and LS are simple and reliable non-invasive tools for predicting OV and large OV. Their association with FIB-4 score improves their diagnostic accuracy.

摘要

简介

慢性肝脏疾病中门静脉高压的无创评估是一个热门话题。

目的

评估脾脏硬度（SS）和肝脏硬度（LS）在预测慢性乙型肝炎患者食管静脉曲张（OV）存在中的准确性，并确定一种无创复合评分。

方法

这是一项单中心横断面研究，包括慢性乙型肝炎携带者。所有患者均接受脉冲弹性成像（FibroScan Echosens）的 SS 和 LS 测量、FIB-4 评分计算和食管胃十二指肠内镜检查。

结果

我们共纳入 84 例患者，平均年龄为 49.04 ± 12.8 岁。在存在 OV 的情况下，SS 和 LS 的平均值明显更高；p=0.000。在分别为 33.1 KPa 和 43KPa 的阈值下，SS 能够预测 OV 和大 OV 的存在，AUROC 为 0.795 和 0.906。在分别为 7.75 KPa 和 13.55 KPa 的阈值下，LS 能够预测 OV 和大 OV 的存在，AUROC 为 0.836 和 0.894。SS、LS 和 FIB-4 值的算术和能够预测 OV 和大 OV 的存在，AUROC 为 0.918 和 0.942。