CT参数联合FIB-4和血清BNP、HIF-1α水平对乙型肝炎肝硬化患者并发食管静脉曲张的预测效能

摘要/Abstract

摘要： 目的分析CT参数联合纤维化-4因子(FIB-4)、血清脑钠肽(BNP)和缺氧诱导因子-1α(HIF-1α)对乙型肝炎肝硬化患者并发食管静脉曲张(EV)的预测效能。方法纳入2022年6月至2024年6月蒙城县第二人民医院收治的乙型肝炎肝硬化患者106例,分为EV组50例和无EV组56例。所有患者均行CT检查,记录门静脉内径(MPV)、脾静脉内径(SPV)和胃左静脉直径(LGV),计算FIB-4,化学发光法检测血清BNP和HIF-1α水平,以受试者工作特征曲线下面积(AUC)评估联合预测EV的效能。结果 EV组脾脏体积、MPV、LGV、FIB-4、血清BNP和HIF-1α分别为(592.33±83.30)cm³、(15.31±1.50)mm、(6.04±1.10)mm、(5.97±1.46)、(183.23±21.38)pg/mL、(22.14±5.03)pg/L,高于无EV组的(457.70±77.46)cm³、(12.25±1.22)mm、(4.53±0.62)mm、(4.58±0.95)、(161.36±16.75)pg/mL、(17.57±4.27)pg/L,差异有统计学意义(P<0.05)。脾脏体积、MPV、LGV、FIB-4、BNP和HIF-1α联合预测肝硬化患者发生EV的灵敏度和特异度分别为94.0%和92.9%,AUC为0.954。结论 CT参数联合FIB-4、血清BNP和HIF-1α预测乙型肝炎肝硬化患者并发EV的效能良好。

关键词: 乙型肝炎肝硬化, 食管静脉曲张, CT参数, 纤维化-4因子, 脑钠肽, 缺氧诱导因子-1α

Abstract: Objective To analyze the efficacy of CT parameters combined with fibrosis-4 factor (FIB-4), serum brain natriuretic peptide (BNP), and hypoxia-inducible factor-1α (HIF-1α) levels in predicting esophageal varices (EV) in patients with hepatitis B-related cirrhosis.Methods This study included 106 patients with hepatitis B-related cirrhosis admitted to the Second People's Hospital of Mengcheng from June 2022 to June 2024. According to the presence of EV, patients were divided into an EV group (50 cases) and a non-EV group (56 cases). All patients underwent CT examination. Professional software was used to measure liver and spleen volumes, as well as to record the diameters of the main portal vein (MPV), splenic vein (SPV), and left gastric vein (LGV), FIB-4 was calculated, and serum BNP and HIF-1α levels were measured using the ELISA method. The efficacy of combined prediction for EV was evaluated using ROC curves.Results The spleen volume, MPV, LGV, FIB-4, serum BNP, and HIF-1α levels in the EV group were (592.33±83.30) cm³, (15.31±1.50) mm, (6.04±1.10) mm, (5.97±1.46), (183.23±21.38) pg/mL, and (22.14±5.03) pg/L, respectively, which were higher than those in the non-EV group [(457.70±77.46) cm³, (12.25±1.22) mm, (4.53±0.62) mm, (4.58±0.95), (161.36±16.75) pg/mL, (17.57±4.27) pg/L] (P<0.05). The combined sensitivity and specificity of spleen volume, MPV, LGV, FIB-4, BNP, and HIF-1α were 94.0% and 92.9%, respectively, with an AUC of 0.954.Conclusion The combination of CT parameters, FIB-4, serum BNP, and HIF-1α levels demonstrates good efficacy in predicting the occurrence of EV in patients with hepatitis B-related cirrhosis, making it worthy of clinical application. This combined predictive method not only enhances the accuracy of assessing the risk of esophageal varices but also provides effective intervention guidelines for clinicians, and contributes to improving patient outcomes.

Key words: Hepatitis B-related cirrhosis, Esophageal varices, CT parameters, Fibrosis-4 factor, Brain natriuretic peptide, Hypoxia-inducible factor-1α

宋迎雨, 王艳, 张宏. CT参数联合FIB-4和血清BNP、HIF-1α水平对乙型肝炎肝硬化患者并发食管静脉曲张的预测效能[J]. 肝脏, 2025, 30(3): 319-321.

SONG Ying-yu, WANG Yan, ZHANG Hong. An analysis on the efficacy of CT parameters combined with FIB-4 and serum BNP, HIF-1α levels in predicting esophageal varices in patients with hepatitis B-related cirrhosis[J]. Chinese Hepatolgy, 2025, 30(3): 319-321.

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