临床肝胆病杂志2018，Vol.34Issue(3)：508-512,5.DOI:10.3969/j.issn.1001-5256.2018.03.011
脾脏ARFI弹性值与APRI及AAR指数对肝硬化食管静脉曲张的预测价值
Clinical value of spleen acoustic radiation force impulse,aspartate aminotransferase-to-platelet ratio index,and aspar-tate aminotransferase/alanine aminotransferase ratio in predicting esophageal varices in patients with liver cirrhosis
摘要
Abstract
Objective To investigate the spleen stiffness of patients with chronic hepatitis and liver cirrhosis by spleen acoustic radiation force impulse(ARFI),aspartate aminotransferase-to-platelet ratio index(APRI),and aspartate aminotransferase/alanine aminotrans-ferase ratio(AAR),as well as the clinical value of these three noninvasive techniques in predicting esophageal varices(EV)in patients with liver cirrhosis. Methods A total of 247 patients with chronic hepatitis and liver cirrhosis were enrolled,and ARFI was used to measure real-time spleen stiffness. APRI and AAR were calculated. Gastroscopy was performed within one week before and after measurement to clarify the degree of EV. With the results of gastroscopy as the gold standard,the receiver operating characteristic(ROC)curve was used to compare the clinical value of spleen ARFI value,APRI,and AAR in the diagnosis of EV in patients with liver cirrhosis. The t-test was used for comparison of continuous data between two groups. Results There were significant differences between the EV group(n=169) and the non-EV group(n=78)in spleen ARFI stiffness(3.64 ± 0.53 m/s vs 2.97 ± 0.65 m/s,t= -7.93,P<0.001),APRI(0.87 ± 0.91 vs 0.52 ± 0.80,t= -2.90,P=0.004),and AAR(1.54 ± 0.67 vs 1.29 ± 0.55,t= -2.93,P=0.004). Spleen ARFI,APRI, and AAR had an area under the ROC curve of 0.80,0.72,and 0.63,respectively,in predicting EV in patients with liver cirrhosis;there was a significant difference between spleen ARFI stiffness and AAR(P=0.005),while there was no significant difference between spleen ARFI stiffness and APRI(P=0.10). Conclusion ARFI is a real-time ultrasound elastography technique,and compared with APRI and AAR,spleen stiffness measured by ARFI can predict EV in patients with chronic hepatitis and liver cirrhosis more accurately and noninva-sively and thus holds promise for clinical application.关键词
弹性成像技术/肝硬化/食管疾病/静脉曲张Key words
elasticity imaging techniques/liver cirrhosis/esophageal diseases/varicose veins分类
医药卫生引用本文复制引用
张大鹍,陈敏,皋月娟,李猛,王瑞芳..脾脏ARFI弹性值与APRI及AAR指数对肝硬化食管静脉曲张的预测价值[J].临床肝胆病杂志,2018,34(3):508-512,5.基金项目
首都临床特色应用研究专项课题(Z161100000516174) （Z161100000516174）
