肝脏超声血流参数联合肝脾硬度检测预测乙型肝炎肝硬化并发食管静脉曲张破裂出血价值研究*

doi:10.3969/j.issn.1672-5069.2025.03.024

Abstract

Abstract: Objective The aim of this study was to explore prediction of esophageal varices bleeding (EVB) by liver ultrasound blood flow parameters and liver stiffness measurement (LSM) and spleen stiffness measurement (SSM) in patients with liver cirrhosis (LC). Methods 89 patients with hepatitis B-induced LC were enrolled in our hospital between January 2022 and February 2023, all underwent gastroscopy and EV was recorded and classified. All patients underwent Doppler ultrasonography to detect portal vein diameter (PVD), congestion index of portal vein (PV-CI), portal vein velocity (PVV) and damping index of hepatic vein (HV-DI). LSM and SSM were detected by FibroTouch. The sensitivity (Se) and specificity (Sp) of different indexes in predicting EVB were analyzed by area under the receiver operating characteristic (ROC) curve (AUC). Results Gastroscopy showed EV in 57 cases(64.1%)in our series; HV-DI, PVD, PV-CI as well as LSM and SSM in patients with EV were (0.9±0.2), (1.7±0.4)cm, (0.4±0.1)cm/s, (19.3±3.6)kPa and (46.1±11.6)kPa, all significantly higher than [(0.7±0.1), (1.4±0.2)cm, (0.2±0.1)cm/s, (12.3±3.1)kPa and (34.5±7.9)kPa, respectively, P<0.05], while PVV was (15.8±3.3)cm/s, significantly lower than [(19.2±2.5)cm/s, P<0.05] in those without EV; HV-DI, PVD, PV-CI, LSM and SSM in 16 patients with severe EV were significantly higher than in 20 patients with moderate EV or in 21 patients with mild EV, while PVV was much lower than in with moderate or mild EV (P<0.05); during one year of follow-up, EVB occurred in 34 cases (59.7%) of 57 patients with EV; ROC analysis showed that HV-DI, PVV, PVD, PV-CI, LSM and SSM could predict EVB occurrence, and combination of them had a satisfactory efficacy, with the AUC of 0.885(95%CI:0.757-0.916), Se of 97.1% and Sp of 80.0%, much superior to mono-parameter(P<0.05). Conclusion Liver ultrasonic blood flow parameters and LSM and SSM combination has a high efficacy in predicting EVB occurrence in patients with LC, which warrants further clinical investigation.

Key words: Liver cirrhosis, Esophageal varices bleeding, Portal vein diameter, Liver stiffness measurement, Spleen stiffness measurement, Prediction

Liu Yuhua, Zhang Yuan, Guo Jiating. Prediction of esophageal varices bleeding by liver ultrasound blood flow parameters and liver and spleen stiffness measurement in patients with liver cirrhosis[J]. Journal of Practical Hepatology, 2025, 28(3): 414-417.

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Prediction of esophageal varices bleeding by liver ultrasound blood flow parameters and liver and spleen stiffness measurement in patients with liver cirrhosis

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