纤支镜非侵入性肝脏硬度测量在预测肝硬化患者有临床意义的门静脉高压中的作用

F. Bouhamou, M. Salihoun, I. Serraj, N. Kabbaj
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引用次数: 0

摘要

背景:肝脏僵硬度测量(LSM)被认为是估计肝纤维化严重程度和肝硬化并发症的一种无创方法。肝静脉压力梯度(HVPG)测量是评估是否存在门脉高压的金标准,但其侵入性限制了其临床应用。我们的研究旨在探讨 LSM 是否能预测肝硬化患者食管静脉曲张(EV)的大小,从而将上内镜手术仅限于真正需要的患者(EV 过大或有出血风险的患者)。研究方法我们的回顾性研究包括 46 名肝硬化患者,时间跨度为 2019 年 1 月至 2022 年 4 月,历时 40 个月,在 RABAT 伊本-西纳大学医院肝-胃肠病学消化功能检查处进行,所有患者都接受了瞬态弹性成像纤维扫描肝硬度测量。结果46例肝硬化患者的平均年龄为58.5(21-90)岁,其中18例(39.1%)为男性,28例(60.9%)为女性。诊断大EV(EV≥II)的ROC曲线下面积为0.724(95%CI)。弹性的最佳临界值为 20.5,灵敏度为 66.7%,特异度为 94.74%。结论:这些结果表明,瞬态弹性成像 FibroScan 是评估门静脉高压症的一种可靠、无创的方法,可用于筛查和诊断具有临床意义的门静脉高压症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Usefulness of Non-Invasive Liver Stiffness Measurements by Fibroscan in Predicting Clinically Significant Portal Hypertension in Cirrhotic Patients
Background: Liver stiffness measurement (LSM) has proposed as a non-invasive method for estimating the severity of fibrosis and the complications of cirrhosis. Measurement of the hepatic venous pressure gradient (HVPG) is the gold standard for assessing the presence of portal hypertension, but its invasiveness limits its clinical application. The aim of our study is to investigate if LSM could predict the size of Esophageal varices (EV) in patients with liver cirrhosis to limit upper endoscopic procedures only to those patients that really need it (patients with large EV or EV at risk for bleeding). Methods: Our retrospective study includes 46 cirrhotic patients over a period of 40 months between January 2019 and April 2022, at the Service of Digestive Functional Explorations of Hepato-gastroenterology of the University hospital Ibn-Sina of RABAT, all patients underwent a liver stiffness measurement by Transient elastography FibroScan. Results: Of the 46 cirrhotic patients included in this study, with a mean age of 58.5(21-90) years, 18 (39.1%) of patients were male and 28(60.9%) were female. the predominant etiology of cirrhosis was chronic viral hepatitis C 20 (43.5%). The area under the ROC curve of the diagnosis of large EVs (EV≥II) was 0.724 (95%CI). The optimal cut-off of elasticity was 20.5 for this purpose, with a sensitivity of 66.7%, specificity of 94.74%. Conclusions: these results indicate that Transient elastography FibroScan is a reliable, non-invasive method to assess portal hypertension and can be used for the screening and diagnosis of clinically significant portal hypertension.
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