脾脏ARFI弹性值与APRI及AAR指数对肝硬化 食管静脉III丨张的预测价值.

Objective To investigate the spleen stiffness of patients with chronic hepatitis and liver cirrhosis by spleen acoustic radiation force impulse (ARF1) , aspartate aminotransferase - to - platelet ratio index (APR1) , and aspartate aminotransferase/alanine aminotransferase ratio (AAR) , as well as the clinical value of these three noninvasive techniques in predicting esophageal varices (EV) in patients with liver cirrhosis. Methods A total of 247 patients with chronic hepatitis and liver cirrhosis were enrolled, and ARF1 was used to measure real - time spleen stiffness. APR1 and AAR were calculated. Gastroscopy was performed within one week before and after measurement to clarify the degree of EV. With the results of gastroscopy as the gold standard , the receiver operating characteristic ( ROC) curve was used to compare the clinical value of spleen ARF1 value, APRI, and AAR in the diagnosis of EV in patients with liver cirrhosis. The t - test was used for comparison of continuous data between two groups. Results There were significant differences between the EV group ( n = 169) and the non - EV group (n =78 ) in spleen ARF1 stiffness (3. 64 ±0. 53 m/ s vs 2. 97 ±0.65 m/s, t = -7.93, P <0.001) , APRI (0.87 ± 0. 91 vs 0.52 ±0.80, t = -2.90 . P =0.004 ), and AAR (1.54 ±0.67 vs 1.29 ±0.55 , t = -2. 93 , P =0.004). Spleen ARFI, APRI, and AAR had an area under the ROC curve of 0. 80,0.72 , and 0. 63 , respectively , in predicting EV in patients with liver cirrhosis; there was a significant difference between spleen ARFI stiffness and AAR (P =0.005) , while there was no significant difference between spleen ARFI stiffness and APRI (P =0.10). Conclusion ARFI is a real -time ultrasound elastography technique, and compared with APRI and AAR, spleen stiffness measured by ARFI can predict EV in patients with chronic hepatitis and liver cirrhosis more accurately and noninva-sively and thus holds promise for clinical application. [ABSTRACT FROM AUTHOR]