摘要目的 探讨瞬时弹性成像技术(FibroScan)、天冬氨酸氨基转移酶和血小板比率指数(APRI)对肝硬化合并食管胃底静脉曲张程度的预测价值. 方法 选取符合标准的236例病毒性肝炎肝硬化患者,所有患者根据电子胃镜检查结果,将患者按照食管胃底静脉曲张程度分为无、轻度、中度、重度4组.患者在行电子胃镜检查3d内检测其肝脏硬度值(LSM)和APRI.多组间数据比较采用单因素方差分析,绘制LSM、APRI、LSM+APRI对肝硬化合并食管胃底静脉曲张患者的受试者工作特征(ROC)曲线,并比较其ROC曲线下面积. 结果 轻度食管胃底静脉曲张患者的LSM、APRI、LSM+APRI的ROC曲线下面积分别是0.856、0.900、0.906;中度食管胃底静脉曲张患者的LSM、APRI、LSM+APRI的ROC曲线下面积分别是0.857、0.924、0.923;重度食管胃底静脉曲张患者的LSM、APRI、LSM+APRI的ROC曲线下面积分别是0.801、0.903、0.901.结论 APRI及LSM+APRI对肝硬化患者合并食管胃底静脉曲张程度具有较好的预测价值.

abstractsObjective To investigate the predictive value of transient elastography (FibroScan),aspartate aminotransferase-to-platelet ratio index (APRI) in the detection of esophagogastric varices in patients with liver cirrhosis.Methods 236 patients with liver cirrhosis who met the criteria were selected.All patients underwent gastroscopy.According to the degree of esophagogastric varices,patients were divided into four groups:none,mild,moderate,and severe.The patient's liver stiffness (LSM) and aspartate aminotransferase-to-platelet ratio index (APRI) were measured within 3 days of gastroscopy.One-way analysis of variance was used to compare multi-group data.The ROC curves of LSM,APRI,LSM+APRI in patients with liver cirrhosis with esophageal varices were plotted and their area under the ROC curve (AUC) were compared.Results The area under the ROC curve of LSM,APRI,LSM + APRI in patients with mild esophagogastric varices were 0.856,0.900,and 0.906,respectively;moderate esophagogastric varices were 0.857,0.924,and 0.923 respectively;and severe esophagogastric varices were 0.801,0.903,and 0.90l,respectively.Conclusion APRI and LSM+APRI have better predictive value for patients with cirrhosis who have esophagogastric varices.