Abstract:【Objective】To study the relationship between Fibroscan, aspartate aminotransferase to platelet ratio index (APRI), and cirrhosis portal hypertensive gastropathy (PHG) and analyze the clinical significance of combined detection of the two methods in the diagnosis of PHG. 【Methods】A total of 116 cases of hepatitis B infection-related liver cirrhosis were detected for liver stiffness measurement (LSM), APRI, degree of esophageal varices (EV), portal vein diameter (PVD), platelet count/spleen diameter (PC/SD), and PHG. The relationships between LSM, APRI and EV, PVD, and PC/SD were analyzed and the differences of LSM and APRI were compared in varying degrees of PHG patients. Then, the receiver operating characteristic curves (ROC) of LSM and APRI were drawn to diagnose PHG. 【Results】The differences were statistically significant for LSM and APRI in varying degrees of EV. LSM and APRI have correlation with PVD and PC/SD. Also, LSM and APRI in patients with varying degrees of PHG were statistically significant. AUROC of Fibroscan for PHG was 0.80(0.71~0.89, the sensitivity was 78.91%, and the specificity was 73.08%. The AUROC of APRI for PHG was 0.80(0.70~0.90), the sensitivity was 65.83%,and the specificity was 92.27%. The AUROC of the combined method for PHG was 0.95(0.89~1.00), the sensitivity was 86.77%,and the specificity was 98.10%. 【Conclusion】FibroScan and APRI reflected the degree of portal hypertension and PHG in liver cirrhosis patients. The combined detection of the two methods was more helpful to improve the accuracy of diagnosis, and it had certain clinical value for the noninvasive diagnosis of PHG.
赵智;章保新;刘小利. Fibroscan联合APRI在肝硬化门脉高压性胃病中的应用价值[J]. 医学临床研究, 2016, 33(10): 1952-1955.
ZHAO Zhi, ZHANG Bao-hua, LIU Xiao-li. Application Value of Fibroscan Combined with APRI in the Diagnosis of Cirrhosis Portal Hypertensive Gastropathy. JOURNAL OF CLINICAL RESEARCH, 2016, 33(10): 1952-1955.
[1] 马淑云,孙国辉,张婕,等.肝硬化非静脉曲张消化道出血临床特征[J].胃肠病学和肝病学杂志,2015,24(11):1324-1326. [2] Thabut D, Simon M, Myers RP,et al. Noninvasive prediction of fibrosis in patients with chronic hepatitis C[J].Hepatology,2003,37(5):1220-1221. [3] 李鹏,李扬,谭嗣伟,等.门静脉高压性胃病小鼠模型的建立[J].新医学,2012,43,(5):318-321. [4] 中华医学会肝病学分会、中华医学会感染病学分会. 慢性乙型肝炎防治指南(2015年版) [J].中华实验和临床感染病杂志(电子版),2015,9(5):570-589. [5] 曾祥华,石代蓉,王宇明.Fibroscan 用于慢性肝病临床诊治新进展[J].中国实用内科杂志,2014,34(12):1185-1188. [6] Wong JS,Wong GL,Chan AW,et al.Liver stiffness measurement by transient elastography as a predictor on posthepatectomy outcomes[J].Ann Surg,2013,257( 5):922-928. [7] Gobel T, Schadewaldt-Tümmers J, Greiner L,et al. Transient elastography improves detection of liver cirrhosis compared to routine screening tests[J].World J Gastroenterol,2015,21(3):953-960. [8] 潘劲劲,孙秋林.天冬氨酸转氨酶与血小板比值在转氨酶正常值上限两倍以下慢性乙型肝炎病毒感染者中的临床应用评价[J].中华传染病杂志,2014,32(1):48-51. [9] 刘京,刘映霞,董常峰.ARFI、Forns指数、FIB-4和APRI无创诊断慢性乙型病毒性肝炎肝纤维化的研究[J].中国肝脏病杂志,2014,6(1):18-21. [10] World Health Organization. Guidelines for the Prevention,Care and Treatment of Persons with Chronic Hepatitis B Infection[R]. Geneva:World Health Organization,2015.