关键词: 瞬时弹性成像, 天冬氨酸转氨酶-血小板比值, 门静脉宽度, 肝硬化

Abstract: Objective To analyze the value of transient elastography, aspartate aminotransferase (AST) -platelet ratio (PLT) (APRI) index and portal vein width in evaluating the severity of liver cirrhosis. Methods Seventy-five patients with liver cirrhosis admitted to Yingde People's Hospital of Guangdong Province from July 2021 to June 2024 were selected. Before treatment, portal vein width was measured by abdominal computed tomography (CT) and liver stiffness measurement (LSM) was performed by instantaneous elastic imaging technology. The aspartate aminotransferase (AST) and platelet (PLT) levels of patients were collected and APRI index was calculated. The Child-Pugh scoring standard was adopted, and the grades were scored and graded through various imaging examinations and laboratory examinations. Grade A and B patients were included in the mild to moderate group, and grade C patients were included in the severe group. By comparing the basic data of patients in the severe group and the mild to moderate group, the influencing factors and value of instantaneous elastography, APRI and portal vein width in evaluating the severity of cirrhosis were analyzed, and the correlation between instantaneous elastography, APRI, portal vein width and the severity of cirrhosis was analyzed. Results In the study involving 75 patients with cirrhosis, the severity of the condition was categorized into three groups: 18 patients with severe cirrhosis, 26 with moderate cirrhosis, and 31 with mild cirrhosis. The APRI level, LSM level, and portal vein diameter were significantly higher in the severe group when compared to the mild and moderate groups (P<0.05). Specifically, LSM {odds ratio (OR)=2.740, 95% CI=1.564~4.801}. and APRI level (OR=17.500, 95%CI=2.253~135.922), portal vein width (OR=18.962, 95%CI=3.056~117.653) were the influential factors in predicting the severity of cirrhosis (P<0.05). According to receiver operating characteristic (ROC) curve analysis, the sensitivity of APRI, portal vein width, LSM and combined assessment of the severity of cirrhosis were 61.10%, 61.10%, 72.20% and 88.90%, respectively, and the specificity were 68.40%, 75.40%, 71.90% and 70.20%, respectively. The combination of APRI, portal vein width and LSM had a high value in predicting the severity of cirrhosis (AUC=0.922). Pearson correlation analysis showed that the values of APRI, LSM and portal vein width were positively correlated with the severity of cirrhosis (P<0.05). Conclusion The instantaneous elastic imaging technique, APRI index and portal vein width are correlated with the severity of cirrhosis, and the combined detection has a higher value in predicting the severity of cirrhosis.

Key words: Instantaneous elastic imaging, APRI, Portal vein width, Liver cirrhosis