【摘要】 目的探讨无创肝纤维化检测系统(FibroTouch)联合AST-血小板比值指数(APRI检测对肝硬化门静脉高压症的诊断价值。方法本研究对象为2016年1月至2018年6月在粤北第二人民医院接受诊治的90例乙型病毒性肝炎(乙肝)后肝硬化患者和慢性乙肝患者。患者均签署知情同意书,符合医学伦理学规定。将患者分为肝硬化组和慢乙肝组,每组各45例。其中肝硬化组男31例,女14例;年龄35～78岁,中位年龄52岁。慢乙肝组男28例,女17例,年龄28～76岁,中位年龄51岁。采用FibroTouch检测肝脏硬度值(LSM),计算APRI,彩色多普勒超声测量门静脉直径,胃镜检查食管静脉曲张程度。检测指标比较采用单因素方差分析或t检验,相关性分析采用Spearman秩相关。结果肝硬化组LSM和APRI分别为(22±7)kPa、2.01±0.35,明显大于慢乙肝组的(8±3)kPa、0.80±0.26(t=3.586,7.305;P<0.05)。肝硬化患者门静脉直径及食管静脉曲张程度与LSM和APRI均成正相关(rs=0.527,0.701和0.803,0.605;P<0.05)。结论 FibroTouch联合APRI检测可较准确地诊断肝硬化门静脉高压症,具有经济、无创、可重复使用优势,且可动态监测门静脉高压症情况。更多还原

【Abstract】 Objective To explore the value of non-invasive liver fibrosis detection system(FibroTouch) combined with aspartate aminotransferase to platelet ratio index(APRI) in the diagnosis of portal hypertension induced by liver cirrhosis. Methods 90 patients diagnosed with liver cirrhosis induced by viral hepatitis B or chronic hepatitis B treated in the Second Yuebei People’s Hospital from January2016 to June 2018 were recruited. The informed consents of all patients were obtained and the local ethical committee approval was received. The patients were divided into the liver cirrhosis group(n=45) and chronic hepatitis B group(n=45). In the liver cirrhosis group, 31 cases were male and 14 female, aged 35-78 years with a median age of 52 years. In the chronic hepatitis B group, 28 patients were male and 17 female,aged 28-76 years with a median age of 51 years. Liver stiffness measurement(LSM) was measured with FibroTouch. APRI was calculated. The diameter of portal vein were measured by color Doppler ultrasound.The severity of esophageal varices was assessed by gastroscopy. All parameters were statistically analyzed by one-way ANOVA or t test. Correlation analysis was conducted by Spearman’s rank correlation analysis.Results The LSM and APRI in liver cirrhosis group were(22±7) kPa and 2.01±0.35, significantly higher than(8±3) kPa and 0.80±0.26 in chronic hepatitis B group(t=3.586,7.305; P<0.05). The portal vein diameter and esophageal varices in patients with liver cirrhosis were positively correlated with LSM and APRI(rs=0.527,0.701 and 0.803, 0.605; P<0.05). Conclusions The combination of FibroTouch and APRI can accurately diagnose portal hypertension induced by liver cirrhosis, which is economical, non-invasive and reusable, and can dynamically monitor the portal hypertension.更多还原