脾刚度测量作为慢性肝病食管静脉曲张的无创替代方法

Pratap Sagar Tiwari, S. Kc
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引用次数: 0

摘要

背景:在慢性肝病患者中,通过弹性成像测量肝脏和脾脏硬度是最新可用的无创工具。然而,在各种研究中,预测食管静脉曲张的准确性并不一致。因此,本研究旨在评价脾刚度测量对食管静脉曲张的诊断价值。材料和方法:本描述性横断面研究于2019年3月19日至6月30日完成。符合纳入和排除标准的参与者被连续纳入研究,并接受上消化道内镜检查,同时通过纤维扫描测量肝脏和脾脏僵硬度。结果:共纳入78例患者。平均年龄(±SD)为49.79(±10.92)岁。78例患者中,58例(74.4%)有食管静脉曲张。在静脉曲张患者中,食管小静脉曲张占44.8%(26例),食管大静脉曲张占55.2%(32例)。肝硬度大于21.7 kPa时,食管静脉曲张较大,受者操作曲线下面积为0.79(95%可信区间:0.69 ~ 0.89);p < 0.001。预测食管大静脉曲张的敏感性为100.0%,特异性为63%。脾脏刚度截止值为40 kPa,受者工作曲线下面积为0.98(95%置信区间:0.96 ~ 1.00);P <0.001,预测食管大静脉曲张的敏感性为100.0%,特异性为87.0%。结论:瞬态弹性图测量脾脏刚度比肝脏刚度更能预测食管大静脉曲张。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Spleen Stiffness Measurement as Non-Invasive Surrogate for Esophageal Varices in Chronic Liver Disease
Background: In patients with chronic liver diseases, liver and spleen stiffness measurement by elastography is the most recent available noninvasive tool. However, the accuracy for prediction of esophageal varices has been inconsistent across various studies. So, this study was done to evaluate the diagnostic performance of spleen stiffness measurement for detecting esophageal varices. Materials and Methods: This descriptive cross-sectional study was done from 19 March to 30 June 2019. Participants who met inclusion and exclusion criteria were consecutively enrolled for the study and underwent upper gastrointestinal endoscopic examination along with measurement of liver and spleen stiffness by fibroscan. Results: A total of 78 patients were enrolled. Mean age (±SD) was 49.79 (±10.92) years. Of 78 patients, 58 (74.4 %) had esophageal varices. Among patients with varices, Small esophageal varices were present in 44.8 % (26) and large esophageal varices were present in 55.2 % (32).Liver stiffness higher than 21.7 kPa was found to detect patients with large esophageal varices and the area under the receiver operating curve being 0.79 (95% confidence interval: 0.69 – 0.89); p<0.001. It had sensitivity of 100.0% and specificity of 63% in predicting the presence of large esophageal varices. While, spleen stiffness having a cutoff value of 40 kPa with the area under the receiver operating curve being 0.98 (95% confidence interval: 0.96 – 1.00); p<0.001, had sensitivity of 100.0 % and specificity of 87.0 % in predicting the presence of large esophageal varices. Conclusion: Spleen stiffness measurements by Transient Elastography predict large esophageal varices better than liver stiffness measurements.
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