现代消化及介入诊疗
現代消化及介入診療
현대소화급개입진료
MODERN DIGESTION & INTERVENTION
2013年
3期
129-131
,共3页
肝硬化%食管静脉曲张%谷草转氨酶%谷丙转氨酶%受试者工作曲线
肝硬化%食管靜脈麯張%穀草轉氨酶%穀丙轉氨酶%受試者工作麯線
간경화%식관정맥곡장%곡초전안매%곡병전안매%수시자공작곡선
Liver cirrhosis%Esophageal varices%Aspartate aminotransferase%Alanine aminoransrease%ROC curve
目的探讨谷草转氨酶/血小板比值指数（APRI）和谷草转氨酶-谷丙转氨酶比值（AAR）预测肝硬化食管静脉曲张的价值。方法肝硬化患者89例，均接受胃镜检查及血生化检验，应用受试者工作曲线评估APRI、AAR预测肝硬化患者食管静脉曲张存在的能力。结果静脉曲张组APRI为2.60±2.54，无静脉曲张组为0.77±0.68，两组相比有统计学意义（P<0.001）；静脉曲张组AAR为1.27±0.53，无静脉曲张组为1.12±0.48，两组相比无统计学意义（P>0.05）。APRI预测食管静脉曲张的曲线下面积为0.84（0.75-0.93），最佳诊断界点为0.93，敏感度76.3%，特异度76.7%。APRI对轻度、中度、重度组食管静脉曲张预测的曲线下面积为0.66（0.47-0.85）、0.84(0.71-0.96)、0.92(0.84-0.99)，最佳诊断值分别为0.7、0.93、1.02，灵敏度分别为54.5%、76.2%、88.9%，特异度为56.7%、76.7%、86.7%。结论 APRI可较好的预测食管静脉曲张的存在，APRI高值可提示重度静脉曲张。对于APRI高于0.93的患者，有必要进行胃镜检查。
目的探討穀草轉氨酶/血小闆比值指數（APRI）和穀草轉氨酶-穀丙轉氨酶比值（AAR）預測肝硬化食管靜脈麯張的價值。方法肝硬化患者89例，均接受胃鏡檢查及血生化檢驗，應用受試者工作麯線評估APRI、AAR預測肝硬化患者食管靜脈麯張存在的能力。結果靜脈麯張組APRI為2.60±2.54，無靜脈麯張組為0.77±0.68，兩組相比有統計學意義（P<0.001）；靜脈麯張組AAR為1.27±0.53，無靜脈麯張組為1.12±0.48，兩組相比無統計學意義（P>0.05）。APRI預測食管靜脈麯張的麯線下麵積為0.84（0.75-0.93），最佳診斷界點為0.93，敏感度76.3%，特異度76.7%。APRI對輕度、中度、重度組食管靜脈麯張預測的麯線下麵積為0.66（0.47-0.85）、0.84(0.71-0.96)、0.92(0.84-0.99)，最佳診斷值分彆為0.7、0.93、1.02，靈敏度分彆為54.5%、76.2%、88.9%，特異度為56.7%、76.7%、86.7%。結論 APRI可較好的預測食管靜脈麯張的存在，APRI高值可提示重度靜脈麯張。對于APRI高于0.93的患者，有必要進行胃鏡檢查。
목적탐토곡초전안매/혈소판비치지수（APRI）화곡초전안매-곡병전안매비치（AAR）예측간경화식관정맥곡장적개치。방법간경화환자89례，균접수위경검사급혈생화검험，응용수시자공작곡선평고APRI、AAR예측간경화환자식관정맥곡장존재적능력。결과정맥곡장조APRI위2.60±2.54，무정맥곡장조위0.77±0.68，량조상비유통계학의의（P<0.001）；정맥곡장조AAR위1.27±0.53，무정맥곡장조위1.12±0.48，량조상비무통계학의의（P>0.05）。APRI예측식관정맥곡장적곡선하면적위0.84（0.75-0.93），최가진단계점위0.93，민감도76.3%，특이도76.7%。APRI대경도、중도、중도조식관정맥곡장예측적곡선하면적위0.66（0.47-0.85）、0.84(0.71-0.96)、0.92(0.84-0.99)，최가진단치분별위0.7、0.93、1.02，령민도분별위54.5%、76.2%、88.9%，특이도위56.7%、76.7%、86.7%。결론 APRI가교호적예측식관정맥곡장적존재，APRI고치가제시중도정맥곡장。대우APRI고우0.93적환자，유필요진행위경검사。
Objective To explore the value of APRI and AAR for the presence of esophageal varices in patient with cirrhosis. Method Eighty-nine patients with liver cirrhosis were prospectively analyzed. Each pa-tient received endoscopy and serum biomarker examination. The receiver operating curve (ROC) was used to assess the relationship of these scores with the presence of esophageal varices. Results APRI in esophageal varices positive group was 2.60 ± 2.54, which was significantly higher than in esophageal varices negative group(0.77 ± 0.68);As for AAR, there was no significant difference between esophageal varices positive group (1.27 ± 0.53) and esophageal varices negative group(1.12 ± 0.48). The area under the curve of APRI were 0.84 (0.75-0.93), and the best diagnosis of cut-off point were 0.93(sensitivity 76.3%,specificity76.7%). The area under the curve of APRI in mild, moderate, and severe esophageal varices groups were 0.66(0.47-0.85), 0.84 (0.71-0.96), 0.92(0.84-0.99). The best diagnosis of cut-off point were 0.7, 0.93, 1.02, sensitivity were 54.5%, 76.2%, 88.9%, specificity were 56.7%, 76.7%, 86.7%. Conclusion APRI could better predict the presence of esophageal varices. When APRI score was more than 0.93, it was necessary for cirrhotic patient to receive en-doscopy examination.
