Liver stiffness measurement selects patients with cirrhosis at risk of bearing large oesophageal varices
Liver stiffness measurement selects patients with cirrhosis at risk of bearing large oesophageal varices
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DOI：
10.1016/j.jhep.2006.04.006
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发表时间：
2006-08-01
影响因子：
25.7
通讯作者：
Beaugrand, Michel
中科院分区：
文献类型：
--
作者：
Kazemi, Farhad;Kettaneh, Adrien;Beaugrand, Michel
背景/目的：推荐对肝硬化患者进行食管静脉曲张的定期内镜筛查，但如果有简单的非侵入性检查可选择有出血风险的患者，则可能仅限于亚组患者。方法：我们研究了165例肝硬化患者，通过内窥镜评估食管静脉曲张的存在与纤维扫描（Fibroscan， R）测量肝脏硬度（一种与肝纤维化相关的无创参数）之间的关系。将结果与反映门脉高压、脾大小、血小板计数和血小板/脾大小比值的其他参数进行比较。结果：肝硬度测量与食管静脉曲张的分级相关（r = 0.6, p < 0.0001）。对于存在食管静脉曲张的患者，肝硬度测量的AUROC值为0.84 (95% CI: 0.784.90)，对于>= II级的患者，AUROC值为0.83（0.76-0.89）。肝硬度测量值< 19 kPa高度预测无食道静脉曲张分级>= II （Se: 84%, PPV: 47%, NPV: 93%）。结论：肝脏硬度测量可以预测肝硬化患者是否存在大食管静脉曲张，并可能有助于选择患者进行内镜筛查。(c) 2006欧洲肝脏研究协会。Elsevier B.V.版权所有。
Background/Aims: Periodic endoscopic screening for oesophageal varices is recommended in patients with cirrhosis, but might be limited to a subgroup of patients if a simple non-invasive test was available to select those at risk of bleeding.Methods: We studied in 165 patients with cirrhosis the relation between the presence of oesophageal varices assessed by endoscopy, and liver stiffness measurement by Fibroscan (R), a non-invasive parameter related to liver fibrosis. The results were compared to those of other parameters reflecting portal hypertension, splenic size, platelet count, and platelet count/ spleen size ratio.Results: Liver stiffness measurement was correlated to the grade of oesophageal varices (r = 0.6, p < 0.0001). AUROC values of liver stiffness measurement were 0.84 (95% CI: 0.784.90) for the presence of oesophageal varices and 0.83 (0.76-0.89) for varices grade >= II. Liver stiffness measurement value < 19 kPa was highly predictive of the absence of oesophageal varicos grade >= II (Se: 84%, PPV: 47%, NPV: 93%).Conclusions: Liver stiffness measurement allows to predict the presence of large oesophageal varices in patients with cirrhosis, and may help to select patients for endoscopic screening. (c) 2006 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.