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J Hepatol:联合SSM与Baveno VI标准可能有助于排除代偿性晚期肝硬化患者的高风险静脉曲张

2018-08-31 MedSci MedSci原创

联合SSM与Baveno VI标准可能有助于排除HRV;与单独采用Baveno VI 标准相比,可避免大量不必要的EGDs。

研究背景:最近,Baveno VI指南建议,肝硬度测量(LSM)<20kPa和血小板计数>150,000/mm(3)的代偿性晚期肝病患者 (cACLD),可避免食管十二指肠镜(EGD)检测。本研究旨在评估脾脏硬度检测 (SSM)排除高危静脉曲张(HRV)病人的效能和在大型人群中验证Baveno VI 标准和评估序列使用Baveno VI标准和SSM可以安全地避免内窥镜检查的需要。

研究方法:2012年至2016年期间,回顾性的纳入498例cACLD患者。患者采用瞬时弹性成像测量 LSM/SSM、检测血小板计数和进行EGDs。

研究结果:SSM、LSM、血小板计数和Child-Pugh-B 是HRV的独立预测因子。应用新定义的SSM临界值(≤46kPa)或Baveno VI 标准,在内部验证队列中,35.8% 和 21.7% 的患者,能够避免EGD;采用这两种方法,只有2%的高危静脉曲张患者被漏检。SSM与Baveno VI标准联合,可使额外22.5%的患者避免EGDs,而只有不足5%的患者漏检HRVs。此结果在外部验证队列中得到确认,联合Baveno VI和SSM≤46可使37.4%的患者避免EGDs;相比之下,单独采用Baveno VI标准,可使16.5%的患者避免EGDs。

研究结论:联合SSM与Baveno VI标准可能有助于排除HRV;与单独采用Baveno VI 标准相比,可避免大量不必要的EGDs。

原始出处

Colecchia A, Ravaioli F, Marasco G, et al. A combined model based on spleen stiffness measurement and Baveno VI criteria to rule out high-risk varices in advanced chronic liver disease. J Hepatol, 2018, 69(2), 308-317.

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    2019-02-22 fusion
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    2018-09-02 gwc384
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    2018-08-31 guging

    谢谢!最新的信息读起来就是收获大

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