剪切波弹性成像联合多参数预测模型在肝硬化食管胃底静脉曲张风险分层中的应用

打开文本图片集

[Abstract]Objective：To explore theclinical applicationvalueapredictivemodel basedonshear waveelastography（SWE） andmultipleparametersintheriskstratificationesophagealandgastricvarices（EGV）inpatientswithlivercirrhosis. Methods：Atotal72patientswithlivercirrosiswereenroled.Usingthegastroscopyresultsasthegoldstandard，ll patientsweredividedinto2groups，thenon/mildEGVgroup（34cases）andthemoderate/severeEGVgroup（38cases）.The liverstifnessmeasurement（LS），sleenstiffessmeasurement（S），prtalveindiameter（PVD），portalveinveloity（PV）， splenicveindiameter（SVD），splenicveinvelocity（SVV），spleenthickness，platelet，prothrombintime（PT），prothrombin activity（PTA），nternationalnormalizedratio（INR），totalbilirubin，albumin，andChild-Pughclassifcationwerecompared betweenthetwogroupsThebinarylogisticregressionanalysiswasusedtoscreenforindependentinfluencingfactors the severityEGVandtoconstructapredictivemodel.ROCcurvewasplotedtoevaluatethepredictiveeficacy this model. Results：ThedierenesinLS，SS，PVD，V，VD，SVV，seentickneslatelet，P，TA，I，totaliliruin， Child-Pugh classification between the two groups were all statisticallysignificant （all P<0.05 ）.Logistic regression analysis showedthatSSM，spleenthicknessandalbuminwereindependentifluencingfactorsfortheseverityEGFinliverciosis （all P <0.05）.SSM，spleen thickness，albuminand plateletwere included inthepredictionmodel.ROC curveanalysisshowed thattheAUCsforpredictingtheEGVoccurencewere0.899forSSM，0842forspleenthickness，0.839forplatelet，0.796for albumin，andO.959forthepredictivemodel，andthepredictivemodeldemonstratedthebestdiagnosticeficacy.Conclusion： ThepredictivemodelbasedonSWEandmultipleparametersshowsgooddiagnosticeficacyinpredictingtheriskEGVin patients with liver cirrhosis，providing an important reference for clinical treatment decisions.

[Key words] Cirhosis;Esophageal and gastric varices;Shear wave elastography;Ultrasonography

肝硬化是多种慢性肝病进展至终末期所形成的弥漫性肝纤维化病变，可引起多种并发症，其中，由门静脉高压引起的食管胃底静脉曲张（esophagealandgastricvarices，EGV）是肝硬化常见的严重并发症之一，其破裂出血年发生率高达 5%～15%[1] 。（剩余7172字）