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- Title
肝脾硬度联合血清腺苷脱氨酶对乙型肝炎肝硬化 重度食管静脉曲张的预测价值分析.
- Authors
谢 青; 李 曾; 唐 臻; 李金强; 刘凤娥
- Abstract
Objective To investigate the value of liver stiffness measurement ( LSM) and spleen stiffness measurement ( SSM) based on Fi-broTouch ( FT) transient elastography combined with serum adenosine deaminase ( ADA) in predicting severe esophageal varices ( EV ) in patients with hepatitis B cirrhosis. Methods Related clinical data were collected from 120 patients with hepatitis B cirrhosis who attended Department of Infectious Diseases, Changsha First Hospital, from December 2017 to June 2020. FT was used to measure LSM and SSM, and related examinations were performed, including electronic gastroscopy and serum levels of ADA, hemoglobin, albumin, alanine aminotrans-ferase, and aspartate aminotransferase and platelet count. The serum liver fibrosis markers aspartate aminotransferase — to — platelet ratio in-dex ( APRI), aspartate aminotransferase/alanine aminotransferase ratio ( AAR ), and fibrosis —4 ( FIB —4) were calculated. According to the severity of EV under gastroscopy, the subjects were divided into severe EV group with 58 patients and non — severe EV ( without EV or with mild — to — moderate EV) group with 62 patients. The t — test was used for comparison of normally distributed continuous data between groups, and the Mann — Whitney U test was used for comparison of non — normally distributed continuous data between groups; the chi —square test was used for comparison of categorical data between groups. The Spearman rank correlation test was used to investigate the corre-lation of LSM, SSM, and ADA with severe EV. The receiver operating characteristic ( ROC) curve was used to analyze the efficacy of ISM, SSM, and ADA in the diagnosis of severe EV, and sensitivity and specificity were calculated. A multivariate binary logistic regression analy-sis was performed to calculate the area under the ROC curve ( AUC) of the combined indicators, and the Z test was used for comparison of AUC. Results There were significant differences in LSM, SSM, and ADA between the two groups ( all P <0.05). LSM, SSM, and ADA were positively correlated with severe EV, with a correlation coefficient of 0.686, 0.743, and 0.723, respectively ( all P <0. 05 ) . The optimal cut — off value was 22.35 kPa for LSM, 45.25 kPa for SSM, and 34.50 U/L for ADA in predicting severe EV, with an AUC of O. 746, 0.802, and 0.791, respectively, a sensitivity of 82.8%, 75.9%, and 58.6%, respectively, and a specificity of 65. 6%, 77. 4%, and 90.2%, respectively. LSM + ADA, SSM + ADA, and LSM + SSM + ADA had an AUC of 0.826, 0.853, and 0.907, respectively, in pre-dicting severe EV ( all P <0. 05 ). Conclusion Liver/spleen stiffness combined with serum ADA has a good value in predicting severe EV, which can provide a preliminary diagnostic basis for severe EV in patients who refuse to undergo gastroscopy.
- Publication
Journal of Clinical Hepatology / Linchuang Gandanbing Zazhi, 2021, Vol 37, Issue 6, p1314
- ISSN
1001-5256
- Publication type
Article
- DOI
10.3969/j.issn.1001-5256.2021.06.020