现代仪器与医疗

瞬时弹性成像技术联合血常规及超声参数对肝硬化食管胃静脉曲张程度的预测价值

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王佳伟

现代仪器与医疗 | 临床研究 2026,32(4): 100-106

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现代仪器与医疗 |临床研究 2026 , 32 (4) : 100 -106

瞬时弹性成像技术联合血常规及超声参数对肝硬化食管胃静脉曲张程度的预测价值

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王佳伟

作者信息

蚌埠医科大学第一附属医院医学工程部，蚌埠　233000

作者简介:

王佳伟，男，本科，助理工程师，研究方向：临床工程

Predictive value of transient elastography combined with routine blood parameters and ultrasound parameters for the severity of gastroesophageal varices in liver cirrhosis

Jiawei Wang

Affiliations

Department of Medical Engineering, The First Affiliated Hospital of Bengbu Medical University, Bengbu 233000, China

出版时间: 2026-08-10 doi: 10.11876/mimt202604013

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摘要

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目的

探讨肝脏瞬时弹性成像技术对肝硬化食管胃静脉曲张（gastroesophageal varices，GOV）程度的预测价值。

方法

纳入两个中心502例肝硬化患者，根据胃镜检查结果分为无GOV、轻度GOV、中度GOV及重度GOV4组。收集血小板计数（platelet，PLT）、凝血酶原时间（prothrombin time，PT）及肝脏超声检测结果，采用单因素分析及多因素Logistic回归分析确定GOV发生、进展的独立危险因素。应用瞬时弹性成像技术检测肝脏硬度测量（liver stiffness measurement，LSM）值，分析其在不同程度GOV中的分布特征。采用受试者工作特征（receiver operating characteristic，ROC）曲线评价LSM值联合PLT及脾直径（spleen diameter，SD）对GOV严重程度的预测效能。

结果

502例肝硬化患者中，356例存在GOV。多因素Logistic回归分析显示，PLT和SD是GOV发生及进展的独立危险因素（P均<0.05）。轻度和中度GOV患者的LSM值均显著高于无GOV患者（P均<0.01），但轻、中、重度GOV患者间差异均无统计学意义（P>0.05）。将LSM值分别与PLT、SD联合分层分析发现，随着GOV严重程度的增加，低风险组合（PLT>150×10⁹/L且LSM值<15 kPa，或SD<10 cm且LSM值15~25 kPa）占比逐渐下降，而高风险组合（LSM值>25 kPa联合PLT 100~150×10⁹/L或SD>15 cm）占比显著升高。ROC曲线分析显示，LSM联合PLT及SD预测中、重度GOV的AUC为0.843，优于LSPS。

结论

肝脏瞬时弹性成像技术联合PLT及超声测得的SD可准确预测肝硬化患者中、重度GOV发生，用于识别食管胃静脉曲张破裂出血的高危人群。

关键词

肝硬化 / 食管胃静脉曲张 / 瞬时弹性成像技术 / 肝脏硬度测量

Abstract

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Objective

To investigate the value of transient elastography in predicting the severity of gastroesophageal varices (GOV) in patients with liver cirrhosis.

Methods

A total of 502 patients with liver cirrhosis from two centers were enrolled. Based on endoscopic findings, they were classified into four groups: no GOV, mild GOV, moderate GOV, and severe GOV. Platelet count (PLT), prothrombin time (PT), and abdominal ultrasound parameters were collected. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the occurrence and progression of GOV. Liver stiffness measurement (LSM) was obtained using transient elastography, and its distribution across different GOV grades was analyzed. The predictive performance of LSM combined with PLT and spleen diameter (SD) for GOV severity was evaluated using receiver operating characteristic (ROC) curve analysis.

Results

Among the 502 patients with liver cirrhosis, 356 cases had GOV. Multivariate logistic regression showed that PLT and SD were independent risk factors for both the occurrence and progression of GOV (both P<0.05). LSM values in the mild and moderate GOV groups were significantly higher than those in the no GOV group (both P<0.01), but no significant differences were observed among the mild, moderate, and severe GOV groups. In stratified analyses combining LSM with PLT and SD, the proportion of low-risk combinations (PLT>150×10⁹/L and LSM<15 kPa; or SD<10 cm and LSM 15~25 kPa) decreased progressively with increasing GOV severity, whereas the proportion of high-risk combinations (LSM>25 kPa with PLT 100~150×10⁹/L or SD>15 cm) increased significantly. ROC curve analysis showed that the combination of LSM, PLT, and SD achieved an AUC of 0.843 for predicting moderate to severe GOV, which was superior to LSPS.

Conclusion

Transient elastography combined with PLT and SD measured by abdominal ultrasound can accurately predict the occurrence of moderate and severe GOV in patients with liver cirrhosis, and can be used to identify high-risk populations for esophageal and gastric variceal rupture bleeding.

Key words

Liver cirrhosis / Gastroesophageal varices / Transient elastography / Liver stiffness measurement

引用本文

王佳伟. 瞬时弹性成像技术联合血常规及超声参数对肝硬化食管胃静脉曲张程度的预测价值. 现代仪器与医疗, 2026 , 32 (4) : 100 -106 . DOI: 10.11876/mimt202604013

Jiawei Wang. Predictive value of transient elastography combined with routine blood parameters and ultrasound parameters for the severity of gastroesophageal varices in liver cirrhosis[J]. Modern Instruments & Medical Treatment, 2026 , 32 (4) : 100 -106 . DOI: 10.11876/mimt202604013

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2026年第32卷第4期

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文章信息

doi: 10.11876/mimt202604013

接收时间：2026-04-07
首发时间：2026-10-23
出版时间：2026-08-10

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蚌埠医科大学第一附属医院医学工程部，蚌埠　233000

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
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				栓菌属 Trametes	5	2.39

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