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目的探讨Fibro Touch(FT)检测脾实质厚度>4 cm的慢性肝病患者脾脏与肝脏受控衰减参数(CAP)的相关性,并分析影响检测结果的因素。方法纳入脾实质厚度>4 cm的患者274例。使用FT检测肝脏和脾脏的硬度值和CAP,采用Pearson相关进行相关性分析。结果本组肝脏检测成功率为100%,而脾脏检测成功率为77.4%;274例肝脏和脾脏硬度值分别为(10.07±7.04)k Pa和(21.34±19.41)k Pa,两者之间存在显著性正相关(r=0.548,P<0.000);肝脏和脾脏CAP值分别为(235.90±54.40)d B/m和(245.45±66.59)d B/m,两者之间也存在显著正相关(r=0.443,P<0.000);在BMI<24 kg/m~2、24~28 kg/m~2、≥28 kg/m~2组肝脏CAP值分别为(217.0±45.8)d B/m、(251.6±52.8)d B/m和(299.2±46.0)d B/m,脾脏CAP值分别为(230.4±68.9)d B/m、(261.8±52.8)d B/m和(288.2±41.5)d B/m,两者均随BMI增加有增加趋势(P<0.000);在皮肤-肝包膜距离(SCD)≤20 mm、20~25 mm、≥25 mm组肝脏CAP值分别为(204.5±26.5)d B/m、(237.9±31.1)d B/m和(268.9±60.7)d B/m,脾脏CAP值分别为(229.8±68.4)d B/m、(262.2±54.3)d B/m和(258.4±60.2)d B/m,显示随着SCD的增加肝脏CAP值也增高(P<0.000),而在SCD<25 mm与SCD≥25 mm组间脾脏CAP值无显著性差异(P>0.05);多元回归分析提示BMI是影响肝脏CAP检测的独立因素,而高密度脂蛋白(HDL)是影响脾脏CAP检测的独立因素。结论 FT可用于有效检测肝脏和脾脏CAP值,通过检测脾脏CAP值以判断肝病的价值还需要进一步研究。
Objective To investigate the correlation between spleen and liver controlled attenuation parameters (CAP) in patients with chronic liver disease whose spleen parenchyma thickness> 4 cm by FibroTouch (FT), and to analyze the factors influencing the test results. Methods 274 patients with splenic parenchyma> 4 cm in thickness were enrolled. Using FT to detect the liver and spleen hardness values and CAP, Pearson correlation was used for correlation analysis. Results The successful rate of detection of liver in this group was 100%, while the detection rate of spleen was 77.4%. The hardness values of the liver and spleen in 274 cases were (10.07 ± 7.04) kPa and (21.34 ± 19.41) kPa, respectively (R = 0.548, P <0.000). The CAP values in liver and spleen were (235.90 ± 54.40) d B / m and (245.45 ± 66.59) d B / m, respectively. There was also a significant positive correlation between them (r = 0.443, P <0.000). The CAP of liver in BMI <24 kg / m ~ 2,24 ~ 28 kg / m ~ 2 and ≥28 kg / (251.6 ± 52.8) d B / m and (299.2 ± 46.0) d B / m respectively, and the spleen CAP values were (230.4 ± 68.9) d B / m, 41.5) d B / m, both of which increased with the increase of BMI (P <0.000). The values of CAP in the groups of skin-to-hepatic confluence (SCD) ≤20 mm, (229.5 ± 26.5) d B / m, (237.9 ± 31.1) d B / m and (268.9 ± 60.7) d B / m, and the spleen CAP values were (229.8 ± 68.4) d B / m and (262.2 ± 54.3) d B / m and (258.4 ± 60.2) d B / m, respectively. The results showed that the liver CAP value increased with the increase of SCD (P <0.000), while there was no significant difference in the spleen CAP between SCD <25 mm and SCD≥25 mm (P> 0.05). Multivariate regression analysis suggested that BMI was the key factor affecting liver CAP testing Of independent factors, and high-density lipoprotein (HDL) is an independent factor affecting the spleen CAP detection. Conclusion FT can be used to effectively detect the liver and spleen CAP value, by detecting the spleen CAP value to determine the value of liver disease needs further study.