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目的探讨瞬时弹性成像技术检测肝硬度值(LSM)、脾硬度值(SSM)评估慢乙肝、肝硬化患者高危食管静脉曲张(HREV)的价值。方法瞬时弹性成像仪Fibrotouch(FT)检测95例慢乙肝、肝硬化患者LSM、SSM,根据胃镜分为HREV组及低危食管静脉曲张(LREV)组。应用ROC曲线评价LSM、SSM预测HREV的准确度,并比较两者准确度。结果 HREV组患者49例,LREV组46例,LSM预测HREV的AUROC为0.720,截断值17.6kPa,灵敏度(Se)、特异度(Sp)、阳性预测值(PPV)及阴性预测值(NPV)分别为61.2%、76.1%、73.2%、64.8%;SSM预测HREV的AUROC为0.893,截断值47.0kPa,Se、Sp、PPV、NPV分别为85.7%、87.0%、87.5%、85.1%;SSM预测HREV的准确性优于LSM(Z=2.294,P=0.003)。结论 FT测量LSM、SSM可作为评估慢乙肝、肝硬化患者HREV的无创方法,SSM准确度优于LSM。
Objective To investigate the value of transient elastography in the detection of liver cirrhosis (LSM) and splenomegaly (SSM) in the assessment of high risk esophageal varices (HREV) in patients with chronic hepatitis B and cirrhosis. Methods Fibrotouch (FT) method was used to detect LSM and SSM in 95 patients with chronic hepatitis B and cirrhosis. The patients were divided into HREV group and low risk esophageal varices (LREV) group according to gastroscope. Using ROC curve to evaluate LSM, SSM predicts the accuracy of HREV and compares the accuracy of the two. Results There were 49 cases in HREV group and 46 cases in LREV group. LSM predicted HREV with AUROC of 0.720, cutoff of 17.6 kPa, sensitivity, specificity, SSR predicted HREV was 0.893, cutoff value was 47.0kPa, and Se, Sp, PPV and NPV were 85.7%, 87.0%, 87.5% and 85.1% respectively, SSM predicted HREV Accuracy was better than LSM (Z = 2.294, P = 0.003). Conclusion FT measurement LSM, SSM can be used as a non-invasive method to assess HREV in patients with chronic hepatitis B and cirrhosis, SSM accuracy is better than LSM.