姜曼蕾 许飞

【摘要】 目的：探讨瞬时弹性成像技术（TE）动态监测评估代偿期肝硬化患者短期内食管胃静脉曲张破裂出血（EVB）风险。方法：选取2016年7月-2018年7月本院收治的代偿期肝硬化患者200例。根據6个月内是否发生EVB将其分为对照组（未发生）和观察组（发生），各100例。分别测量患者入院时及治疗3、6个月的肝脏弹性硬度值（LSM）并进行比较。结果：两组患者一般资料比较，差异均无统计学意义（P>0.05）；入院时，两组LSM值比较差异无统计学意义（P>0.05）；治疗3、6个月时，两组LSM值均高于入院时，且观察组均高于对照组，比较差异均有统计学意义（P<0.05）。结论：TE动态监测评估代偿期肝硬化患者短期内EVB风险价值高，值得在临床推广应用。

【关键词】 瞬时弹性成像技术； 代偿期肝硬化； 短期内； 食管胃静脉曲张破裂出血； 风险；动态监测评估

【Abstract】 Objective：To evaluate the short-term risk of esophagogastric variceal bleeding（EVB） of compensated cirrhosis patients by transient elastography（TE） dynamic monitoring.Method：A total of 200 patients with compensated cirrhosis in our hospital from July 2016 to July 2018 were selected.According to whether EVB happened within 6 months，they were divided into control group（not happened） and observation group（happened），100 cases in each group.The elastic hardness values （LSM） of the patients at admission and 3 and 6 months after treatment were measured and compared.Result：The general information between two groups of patients was compared，the difference was not statistically significant（P>0.05）.At admission，the LSM values of two groups was compared，the difference was not statistically significant（P>0.05）.Treatment for 3，6 months，the LSM values of two groups were all higher than those of at admission，and the observation group were higher than those of control group，the differences were statistically significant（P<0.05）.Conclusion：TE has a high value in the assessment of short-term risk of EVB of cirrhotic patients，so it is worthy of clinical promotion and application.

【Key words】 Transient elastography； Compensated cirrhosis； Short-term； Esophagogastric variceal bleeding； Risk； Dynamic monitoring and evaluation

First-authors address：Ganzhou Fifth Peoples Hospital，Ganzhou 341000，China

doi：10.3969/j.issn.1674-4985.2018.33.036

慢性肝病是威胁全世界人类健康的常见疾病。食管胃静脉曲张破裂出血（EVB）是失代偿期肝硬化最危险和最常见并发症，临床治疗风险大，死亡率高，因此如果能在代偿期肝硬化患者出血前评估肝纤维化分期、监测门静脉高压，预判出血风险将对临床预防、优化治疗和评估预后有重要意义[1]；侵袭性血管造影技术是评估门静脉高压的金标准。但是肝静脉压力梯度（HVPG）检测是通过经皮穿刺插管、置入带有球囊导管的方式进行，该方法为侵入性操作，在国内尚未广泛应用[2]。瞬时弹性成像技术（TE）临床应用专家共识（2015）推荐意见：肝脏弹性硬度值（LSM）可预测门脉高压、食管静脉曲张风险，可作为需要内镜筛查的指征（A1）[3]。本院拟将开展瞬时弹性成像技术（TE）动态监测肝硬化患者LSM值及变化与出血相关性研究，了解门静脉高压进展情况，判断近期出血风险，为预测肝硬化食管、EVB出血风险探索有效的检查方法。现报……