当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
1期
10-11,12
,共3页
肝硬化%瞬时弹性扫描%食管静脉曲张%静脉曲张破裂出血
肝硬化%瞬時彈性掃描%食管靜脈麯張%靜脈麯張破裂齣血
간경화%순시탄성소묘%식관정맥곡장%정맥곡장파렬출혈
Liver stiffness%Fibroscan%Esophageal varices%Variceal bleeding
目的：为了确定能否借助瞬时弹性扫描仪(Fibroscan,FS)测定肝硬度（LS）与食管静脉曲张（EV）严重程度的相关性及预测静脉出血的发生。方法选定100例肝硬化患者，按有无EV分成两组：组1：无或1级EV（65例），组2：2或3级明显EV（35例）。又把其中54例EV患者分成两个亚组：组Ⅰ：无出血史（37例），组Ⅱ：有出血史（17例）。通过不成对t检验对比组间LS差异，并通过使用ROC曲线确定EV和出血风险的阈值。结果组1与组2患者相比其平均LS值明显降低。通过ROC曲线确定30kPa为EV存在与否的LS阈值，敏感性83%，特异性62%，阳性预测值76.2%，阴性预测值71.3%。组Ⅱ（17例）的平均LS值明显高于组Ⅰ（37例）患者。51 kPa作为预测食管静脉出血发生的LS阈值，其敏感性为54.1%，特异性为83.0%，阳性预测值为81.5%，阴性预测值为55.1%。结论通过Fibroscan测定LS值是一种检测EV和预测EV破裂出血的可靠无创方法。
目的：為瞭確定能否藉助瞬時彈性掃描儀(Fibroscan,FS)測定肝硬度（LS）與食管靜脈麯張（EV）嚴重程度的相關性及預測靜脈齣血的髮生。方法選定100例肝硬化患者，按有無EV分成兩組：組1：無或1級EV（65例），組2：2或3級明顯EV（35例）。又把其中54例EV患者分成兩箇亞組：組Ⅰ：無齣血史（37例），組Ⅱ：有齣血史（17例）。通過不成對t檢驗對比組間LS差異，併通過使用ROC麯線確定EV和齣血風險的閾值。結果組1與組2患者相比其平均LS值明顯降低。通過ROC麯線確定30kPa為EV存在與否的LS閾值，敏感性83%，特異性62%，暘性預測值76.2%，陰性預測值71.3%。組Ⅱ（17例）的平均LS值明顯高于組Ⅰ（37例）患者。51 kPa作為預測食管靜脈齣血髮生的LS閾值，其敏感性為54.1%，特異性為83.0%，暘性預測值為81.5%，陰性預測值為55.1%。結論通過Fibroscan測定LS值是一種檢測EV和預測EV破裂齣血的可靠無創方法。
목적：위료학정능부차조순시탄성소묘의(Fibroscan,FS)측정간경도（LS）여식관정맥곡장（EV）엄중정도적상관성급예측정맥출혈적발생。방법선정100례간경화환자，안유무EV분성량조：조1：무혹1급EV（65례），조2：2혹3급명현EV（35례）。우파기중54례EV환자분성량개아조：조Ⅰ：무출혈사（37례），조Ⅱ：유출혈사（17례）。통과불성대t검험대비조간LS차이，병통과사용ROC곡선학정EV화출혈풍험적역치。결과조1여조2환자상비기평균LS치명현강저。통과ROC곡선학정30kPa위EV존재여부적LS역치，민감성83%，특이성62%，양성예측치76.2%，음성예측치71.3%。조Ⅱ（17례）적평균LS치명현고우조Ⅰ（37례）환자。51 kPa작위예측식관정맥출혈발생적LS역치，기민감성위54.1%，특이성위83.0%，양성예측치위81.5%，음성예측치위55.1%。결론통과Fibroscan측정LS치시일충검측EV화예측EV파렬출혈적가고무창방법。
Objective To determine if liver stiffness (LS) measurements by means of Fibroscan (FS)correlate with the presence of significant esophageal varices (EV) and if they can predict the occurrence of variceal bleeding. Methods We studied 100 cases of liver cirrhosis divided into 2 groups:patients without EV or with grade 1 varices (65 cases) and patients with significant varices (grade 2 and 3 EV) (35 cases). We divided the group of 54 cases with EV into another 2 subgroups:without variceal hemorrhage (37 patients) and patients with a history of variceal bleeding (17 cases). We compared the LS values between the groups using the unpaired t-test and we established cut-off LS values for the presence of significant EV and for the risk of bleeding by using the ROC curve. Results The mean LS values in the group 1 was statistically significantly lower than in the group 2. Using the ROC curve we established a cut-off value of 30 kPa for the presence of EV, with 83%sensitivity and 62%specificity, with 76.2%positive predictive value (PPV) and 71.3%negative predictive value (NPV).The mean LS values in the groupⅡ(17 patients) was statistically significantly higher than in the groupⅠ(37 patients):For a cut-off value of 51 kPa, LS had 53.33%sensitivityand 82.67%specificity, with 82.71%PPV and 53.66%NPV for the prediction of esophageal bleeding. Conclusion LS measurement by means of FS is a reliable noninvasive method for the detection of EV and for the prediction of variceal bleeding.
