定量CT肝脏脂肪含量联合临床指标预测肝硬化患者食管胃底静脉曲张破裂出血风险的初步研究
Quantitative CT liver fat content combined with clinical indicators in the prediction of the risk of esopha-gogastric variceal bleeding in patients with liver cirrhosis
张成孟 1丁治民 1孙宵宇 1刘春雨 1罗慧 1陈鹏1
作者信息
- 1. 241001 安徽芜湖,皖南医学院弋矶山医院放射科
- 折叠
摘要
目的:采用定量CT(QCT)探讨肝硬化患者肝脏脂肪含量与食管胃底静脉曲张破裂出血(EGVB)的关系.方法:回顾性收集2018年5月—2022年11月经临床病理诊断为肝硬化的患者203例,所有患者均接受了腹部CT平扫、血液生化及胃镜检查,根据胃镜检查结果将患者分为EGVB组(100例)和无EGVB组(103例).采用QCT Pro软件测量每例患者的肝脏脂肪含量.比较两组患者之间的一般资料,将差异有统计学意义的变量纳入多因素二元逻辑回归分析筛选独立预测因子,并以此构建预测模型并绘制动态列线图,采用受试者操作特征(ROC)曲线下面积(AUC)评估模型的鉴别效能,采用布里尔分数(BS)评估模型的校准度.结果:单因素分析表明,肝脏脂肪含量、凝血酶原时间、血红蛋白及Child-Pugh分级对于预测肝硬化患者是否发生EGVB差异具有统计学意义(P＜0.05).多因素二元逻辑回归分析显示,肝脏脂肪含量(OR=1.105,P=0.014)和血红蛋白(OR=0.953,P＜0.001)为预测肝硬化患者发生EGVB的独立预测因子,以此构建的列线图模型AUC为0.798,Brier得分为0.183,模型表现出较高的预测能力和较好的校准度.结论:对于肝硬化患者,肝脏脂肪含量增加和血红蛋白的降低会增加EGVB发生的风险.
Abstract
Objective:This preliminary study aimed to examine the relationship between liver fat content and esophagogastric variceal bleeding(EGVB)in patients with cirrhosis using Quantitative Computed Tomography(QCT).Methods:A retrospective analysis of 203 clinically diagnosed cirrhotic patients between May 2018 and November 2022 was performed.All patients underwent abdominal CT plain examination,blood biochemical examination,and gastroscopy.Patients were divided into the EGVB group(100 cases)and the no EGVB group(103 cases)based on the gastroscopy results.The liver fat content of each subject was measured using QCT Pro software.Statistical analysis was con-ducted,and multivariate logistic regression analysis identified independent predictors.These independ-ent predictors were utilized to construct a prediction model.The model's efficacy was assessed using the area under the curve(AUC),and the calibration was evaluated using the Brier score(BS).Results:The study demonstrated statistically significant differences in liver fat content,prothrombin time,hemoglo-bin,and Child-Pugh classification between cirrhotic patients with and without EGVB(P＜0.05).Liver fat content(OR=1.105,P=0.014)and hemoglobin(OR=0.953,P＜0.001)were confirmed as inde-pendent predictors of EGVB in patients with cirrhosis using multivariate regression analysis.The pre-dictive model constructed using these predictors demonstrated high predictive ability and good calibra-tion,with an AUC of 0.798 and a Brier score of 0.183.Conclusion:This study concluded that increased liver fat content and decreased hemoglobin increase the risk of EGVB in patients with cirrhosis.
关键词
肝硬化/食管和胃静脉曲张/肝脏脂肪含量/定量CTKey words
Cirrhosis/Esophageal and gastric varices/Liver fat content/Quantitative compu-ted tomography引用本文复制引用
基金项目
中国红十字基金会医学赋能-领航菁英科研项目(XM_HR_YXFN_2021_05_24)
安徽省卫生健康科研项目(AHWJ2022b044)
安徽省教育厅2022年度新时代育人质量工程项目(研究生教育)(2022zyxwjxalk165)
皖南医学院第一附属医院(弋矶山医院)引进人才专项科研基金项目(YR20220219)
安徽省高校自然科学研究重大项目(2023AH040253)
出版年
2024
NETL
NSTL
万方数据