利用瞬时弹性成像技术测量慢性肝病肝硬化患者肝硬度值及脾硬度值.docVIP

【摘要】目的 利用瞬时弹性成像技术测量慢性肝病肝硬化患者肝硬度值及脾硬度值, 评估不同Child-Pugh分级、食管胃底静脉曲张程度、出血情况慢性肝病肝硬化患者肝硬度值及脾硬度值的差异。方法 选取2011年4月—2014年12月天津市第三中心医院住院的所有接受电子胃镜检查的肝硬化患者340例为研究对象，其中慢性乙型肝炎肝硬化患者170例，慢性丙型肝炎肝硬化患者35例，原发性胆汁性肝硬化46例，酒精性肝病肝硬化患者55例，自身免疫性肝炎肝硬化患者34例，分别检测血常规、凝血常规、肝功能、腹部彩超、电子胃镜以及进行瞬时弹性成像技术检查测量肝硬度值及脾硬度值。结果 不同Child-Pugh分级慢性乙型肝炎肝硬化、慢性丙型肝炎肝硬化、原发性胆汁性肝硬化、酒精性肝炎肝硬化、自身免疫性肝炎肝硬化患者的肝硬度值及脾硬度值比较，差异均有统计学意义（P＜0.05）。不同食管胃底静脉曲张程度慢性乙型肝炎肝硬化、慢性丙型肝炎肝硬化、原发性胆汁性肝硬化、酒精性肝炎肝硬化、自身免疫性肝炎肝硬化患者的肝硬度值及脾硬度值比较，差异均有统计学意义（P＜0.05）。不同出血情况慢性乙型肝炎肝硬化、慢性丙型肝炎肝硬化、原发性胆汁性肝硬化、酒精性肝炎肝硬化、自身免疫性肝炎肝硬化患者的肝硬度值及脾硬度值比较，差异均有统计学意义（P＜0.05）。结论 Child-Pugh 分级越高、食管胃底静脉曲张程度越重、出血情况越重慢性肝病肝硬化患者肝硬度值及脾硬度值越高；瞬时弹性成像技术可以有效地预测慢性肝病肝硬化患者食管胃底静脉曲张出血的风险。 【关键词】肝病食管和胃静脉曲张弹性成像技术Abstract】Objective To measure liver stiffness and spleen hardness of patients with chronic liver disease and cirrhosis by transient elastography (FibroScan), and evaluate the liver stiffness and spleen hardness of patients with different Child-Pugh classification, the degree of esophageal gastric varices and bleeding. METHODS 340 cases with liver cirrhosis (patients with chronic hepatitis B in 170 cases, Chronic hepatitis C in 35 cases, primary biliary cirrhosis in 46 cases, alcoholic liver cirrhosis in 55 cases, and 34 cases of patients with autoimmune hepatitis) in our hospital were selected as research object , and tested routine blood test, routine coagulation, liver function, abdominal ultrasound, electronic gastroscopy and examed the hardness of liver and spleen by FibroScan. RESULTS The liver stiffness and spleen hardness of patients between different Child-Pugh classification, degree of esophageal gastric varices and bleeding all had statistical significance(P0.05). CONCLUSION The liver stiffness and spleen hardness were higher in patients with higher the Child-Pugh classification, the more severe of the degree of esophageal gastric varices, and the more severe of the degree of bleeding. FibroScan can predict the risk of esophageal gastric varices and bleeding effectively. 【Key