摘要
目的旨在寻找一种准确而有效地预测肝静脉压力梯度(HVPG)值的非侵入性方法。方法以2012年9月至2014年5月在山东大学附属省立医院消化内科收集的75例乙型肝炎肝硬化患者为研究对象。所有患者均行CT扫描和HVPG测量,检测肝功、凝血酶原时间(PT)和血小板计数,计算Child-Pugh评分。应用CT图像测量患者的肝脏体积、脾脏体积、门静脉宽度和脾静脉宽度。评估所有变量预测HVPG值的能力,选取预测能力强的变量建立HVPG预测方程。结果 HVPG评分=18.912-7.173×ln(肝脏体积/脾脏体积),该HVPG预测方程的曲线下面积(AUC)、敏感度、特异度、阳性预测值和阴性预测值分别是0.906,92.9%,79.2%,83.9%和90.5%。结论应用肝脾体积比能够预测乙型肝炎肝硬化患者的HVPG值。该预测模型可能作为一种新的预测HVPG值的方法应用于临床。
Objective To find an accurate and effective non-invasive method to predict the value of hepatic venous pressure gradient（HVPG）. Methods A total of 75 cirrhotic patients with hepatitis B were enrolled. All patients underwent computed tomography（CT）,transjugular HVPG measurement,liver function test,prothrombin time（PT） recording and platelet counting. Liver and spleen volumes,the internal diameters of portal and splenic veins,and the presence of ascites were measured by CT. The Child-Pugh score for each patient was calculated. We assessed the ability of all variables to predict HVPG values. The variables with the highest ability to predict the HVPG value were applied to construct a model to predict HVPG12mm Hg. Results The predictive model with liver/spleen volume ratio was constructed for predicting HVPG values. The following equation was： HVPG score = 18.912 – 7.173×ln（liver/spleen volume）. The values of sensitivity,specificity,positive and negative predictive value of the equation were 92.9%,79.2%,83.9% and 90.5% respectively. The area under the curve（AUC） of this predictive equation was 0.906. Conclusions Liver/spleen volume ratio can accurately predict HVPG value in patients with hepatitis B associated cirrhosis.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2015年第3期232-235,共4页
Chinese Journal of Practical Internal Medicine
基金
国家自然科学基金资助(81370554)
