肝脏剪切波束预测哈萨克族肝硬化合并食管胃底静曲张的价值

Value of Shear Wave Velocity of Liver in Predicting Esophageal Varices of Kazak Cirrhosis

目的探讨肝脏剪切波速参数(SWV)对哈克族肝硬化合并食管胃底静脉曲张(EV)的预测价值。方法选取新疆伊犁州奎屯医院哈萨克族肝硬化患者35例(肝硬化组),以同期不同族别的30例慢性肝炎(酒精性或乙型病毒性)作为对照组。采用声辐射力脉冲成像(ARFI)测量两组肝脏、脾脏剪切波速(SWV)。将肝硬化组患者的胃镜检查结果作为金标准,制作肝、脾脏SWV参数ROC曲线,并计算曲线下面积,评估SWV对EV的预测价值。结果肝硬化组SWV是(1.96+0.34)m/s,脾脏组SWV是(3.12+0.56)m/s,均高于对照组肝SWV[(1.26+0.26)m/s脾脏组为(2.08+0.24)m/s],差异均有统计学意(P<0.05)中度及重度EV患者肝、脾脏SWV参数均明显升高,并且哈萨克族患者SWV高于汉族,肝硬化组脾脏SWV参数预测中-重度EV曲线下面积为0.905,大于肝脏SWV参数预测中-重度EV的曲线下面积为0.801。结论肝脏SWV参数和脾脏SWV参数是均可以预测哈萨克族肝硬化EV的一种有效的非侵入性方法,预测哈萨克族肝硬化并EV患者比同样预测汉族患者的特异性高,其中脾脏SWV参数预测能力更佳,可以弥补肝脏预测的局限;二者对临床肝硬化合并EV的诊治具有重要参考价值。

Abstracr:Objective to explore the value of shear wave velocity(SWV)0 f Liver in predicting esophoageal varices(EV)of kazak cirrhosis. Methoes thirty-five Kazak Patients with liver cirrhosis were involved in this study,taking 30 chronic hepatitis(alcoholic or B virus) in the same period as control group. Acoustic radiation force imaging(ARFI)of liver was performed in all patients,and the SWV was recorded twice.The ROC curve was analyzed,taking the endoscopy results as the gold standard,and thearea under curve(AUC)was calculated. Results the SWV values of liver were(1.96+0.34)m/s and(1.26+0.26)m/s inpatients with cirrhosis group and the control group(P<0.05). SWV values of liver and spleen were increased obviously in patients with moderate and serve EV,and AUCs of them were 0.801 and 0.905,respectively. Conclusion SWV value of liver and spleen is an non-invasive predictor of EV of kzkak cirrhosis,with important reference value in its clinical diagnosis and treatment.