病毒性肝硬化患者肝脾脏硬度变化及与肝静脉压力梯度的相关性分析

王鹏, 胡新红, 杨桑杰草, 谢峰

PDF(684 KB)
PDF(684 KB)
重庆医科大学学报 ›› 2024, Vol. 49 ›› Issue (02) : 179-182. DOI: 10.13406/j.cnki.cyxb.003422
临床研究 DOI:10.13406/j.cnki.cyxb.003422

病毒性肝硬化患者肝脾脏硬度变化及与肝静脉压力梯度的相关性分析

作者信息 +

Correlation between liver/spleen stiffness and hepatic venous pressure gradient in patients with viral liver cirrhosis

Author information +
History +

摘要

目的 探究病毒性肝硬化患者肝脾脏硬度变化及与肝静脉压力梯度的相关性。 方法 将2020年9月至2021年12月在兰州市第二人民医院超声科进行病毒性肝硬化治疗的82例患者作为研究对象,检测患者肝静脉压力梯度(hepatic venous pressure gradient,HVPG)和肝脾硬度。采用Pearson相关性分析评估病毒性肝硬化患者肝脾脏硬度变化与肝静脉压力梯度的相关性;并采用受试者工作特征(receiver operating characteristic,ROC)曲线评估肝脾脏硬度对肝硬化患者HVPG≥12 mmHg的预测价值。 结果 病毒性肝硬化Child-pugh B级和Child-pugh C级患者HVPG(F=16.643,P<0.001)、肝脏硬度(F=14.403,P<0.001)、脾脏硬度(F=11.775,P<0.001)明显高于Child-pugh A级患者。患者HVPG与肝脏硬度和脾脏硬度均呈正相关(r=0.591,0.502,P<0.001)。肝脏硬度、脾脏硬度及联合分析预测肝硬化患者HVPG≥12 mmHg的ROC曲线下面积(area under the curve,AUC)分别为0.866、0.821、0.914。 结论 病毒性肝硬化患者肝脾脏硬度与HVPG呈正相关,且对门静脉高压的无创诊断有一定预测价值。

Abstract

Objective To investigate the change in liver/spleen stiffness and the correlation with hepatic venous pressure gradient (HVPG) in patients with viral liver cirrhosis. Methods We included 82 patients with viral liver cirrhosis treated in The Second People's Hospital of Lanzhou from September 2020 to December 2021. HVPG and liver and spleen stiffness were measured. Pearson correlation analysis was used to evaluate the correlation between changes in liver and spleen stiffness and HVPG in these patients. A receiver operating characteristic(ROC) curve was used to evaluate the predictive value of liver and spleen stiffness for HVPG ≥12 mmHg in patients with viral liver cirrhosis. Results HVPG,liver stiffness,and spleen stiffness were significantly higher in the Child-Pugh class B patients and the Child-Pugh class C patients than in the Child-Pugh class A patients(P<0.05). HVPG was significantly positively correlated with liver stiffness and spleen stiffness(r=0.591,0.502,P<0.001). The areas under the ROC curves for predicting HVPG ≥12 mmHg using liver stiffness,spleen stiffness,and their combination in patients with liver cirrhosis were 0.866,0.821,and 0.914,respectively. Conclusion Liver and spleen stiffness are significantly positively correlated with HVPG in patients with viral liver cirrhosis, which have certain predictive value for portal hypertension in a noninvasive way.

关键词

病毒性肝硬化 / 肝脾脏硬度 / 肝静脉压力梯度

Key words

viral liver cirrhosis / liver and spleen stiffness / hepatic venous pressure gradient

中图分类号

R114

引用本文

导出引用
王鹏 , 胡新红 , 杨桑杰草 , . 病毒性肝硬化患者肝脾脏硬度变化及与肝静脉压力梯度的相关性分析. 重庆医科大学学报. 2024, 49(02): 179-182 https://doi.org/10.13406/j.cnki.cyxb.003422
Wang Peng, Hu Xinhong, Yang Sangjiecao, et al. Correlation between liver/spleen stiffness and hepatic venous pressure gradient in patients with viral liver cirrhosis[J]. Journal of Chongqing Medical University. 2024, 49(02): 179-182 https://doi.org/10.13406/j.cnki.cyxb.003422

参考文献

1
Li PJ. Comparison of five-year survival status of patients with liver cirrhosis and esophagogastric varices bleeding treated by transjugular intrahepatic portosystemic shunt and drug combined with endoscopic treatment[J]. China Med Abstr Intern Med202138(4):221-222.
2
Ginès P Krag A Abraldes JG,et al. Liver cirrhosis[J]. Lancet2021398(10308):1359-1376.
3
朱昌鹏,谢渭芬. 肝硬化门静脉高压逆转的机制及其治疗[J]. 中华肝脏病杂志202230(6):572-576.
Zhu CP Xie WF. Cirrhotic portal hypertension reversal mechanism and its therapy[J]. Chin J Hepatol202230(6):572-576.
4
Takuma Y Nouso K Morimoto Y,et al. Portal hypertension in patients with liver cirrhosis:diagnostic accuracy of spleen stiffness[J]. Radiology2016279(2):609-619.
5
Lunova M Frankova S Gottfriedova H,et al. Portal hypertension is the main driver of liver stiffness in advanced liver cirrhosis[J]. Physiol Res202170(4):563-577.
6
胡利萍,熊静平,努力比亚·阿不都克尤木,等. 肝硬化腹腔积液感染并门静脉血栓形成危险因素及其评估模型预测价值[J]. 中国医药201914(10):1524-1527.
Hu LP Xiong JP Nulibiya A, et al. Risk factors of portal venous thrombosis in cirrhosis patients with ascites infection and the predictive value of evaluation model[J]. China Med201914(10):1524-1527.
of evaluation model[J]. China Medicine, 2019,14(10): 1524-1527.
7
Zhang Y Mao DF Zhang MW,et al. Clinical value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension[J]. World J Gastroenterol201723(45):8044-8052.
8
张 明,诸葛宇征,邹晓平,等. 肝静脉压力梯度与肝硬化患者临床特征的相关性[J]. 中华消化杂志201535(8):530-533.
Zhang M Zhuge YZ Zou XP,et al. Correlation between hepatic venous pressure gradient and clinic features in patients with liver cirrhosis[J]. Chin J Dig201535(8):530-533.
9
Armandi A Labenz C Werner MM,et al. The use of Spleen Stiffness Measurement for the detection of high-risk esophageal varices in patients with portal hypertension[J]. Dig Liver Dis202254:S19-S20.
10
Khanna R Sarin SK. Idiopathic portal hypertension and extrahepatic portal venous obstruction[J]. Hepatol Int201812(Suppl 1):148-167.
11
缪成成,诸葛宇征,张 明,等. 声脉冲辐射力成像测量的肝脏和脾脏硬度与肝静脉压力梯度的相关性分析[J]. 中华消化杂志201737(1):30-34.
12
彭 恒,徐珍望,何 晖. 声脉冲辐射力弹性成像检测肝脏硬度与肝静脉压力梯度相关性分析[J]. 肝脏202025(5):531-533.
Peng H Xu ZW He H. Correlation analysis between liver hardness detected by acoustic pulse radiation force elasticity imaging and hepatic vein pressure gradient[J]. Chin Hepatol202025(5):531-533.
13
吴灵芝,崔祥华,贾继东. 无创检查测定脾脏硬度值对肝硬化门静脉高压的评估价值[J]. 临床肝胆病杂志201632(8):1604-1607.
Wu LZ Cui XH Jia JD. Value of spleen stiffness measured by noninvasive method in evaluating the severity of cirrhotic portal hypertension[J]. J Clin Hepatol201632(8):1604-1607.
14
Gelman S Sakalauskas A Zykus R,et al. Endogenous motion of liver correlates to the severity of portal hypertension[J]. World J Gastroenterol202026(38):5836-5848.
15
Yao HJ Wang YL. Relationship between hemodynamic parameters and portal venous pressure in cirrhosis patients with portal hypertension[J]. Open Life Sci202015(1):981-987.
16
Ravaioli F Colecchia A Dajti E,et al. Spleen stiffness mirrors changes in portal hypertension after successful interferon-free therapy in chronic-hepatitis C virus patients[J]. World J Hepatol201810(10):731-742.

基金

甘肃省自然科学基金资助项目(22JR5RA1069)
兰州市人才创新创业项目(2020-RC-73)

评论

PDF(684 KB)

Accesses

Citation

Detail

段落导航
相关文章

/