식도정맥류의 발생과 출혈 예측에 있어서 순간 탄성 측정법(Fibroscan？)의 유용성 (The usefulness of transient elastography (Fibroscan？) for predicting esophageal varices and esophageal variceal hemorrhage in patients with chronic liver diseases)

서지정보

· 발행기관 : 대한내과학회
· 수록지 정보 : 대한내과학회지 / 74권 / 5호 / 491 ~ 499페이지
· 저자명 : 이시형, 은종렬, 이헌주, 김태년, 장병익, 최재원, 박윤선, 김경옥, 이규형, 문희정, 이상훈

초록

Background/Aims : This study was conducted to evaluate the efficacy of transient elastography (FibroscanⓇ) for predicting esophageal varices and esophageal variceal hemorrhage in patients with chronic liver diseases.
Methods : We studied 245 patients (mean age: 50.1 years, male/female: 181/64) with chronic liver diseases to determine the relation between the clinical or serologic markers associated with liver fibrosis and tissue elastography, and these tests were performed in Feb 2007. The causes of chronic liver diseases were hepatitis B virus in 139 (56.7%), hepatitis C virus in 30 (12.2%), alcohol in 38 (15.5%), nonalcoholic fatty liver disease in 23 (9.4%), autoimmune liver disease in 3 (1.2%), and unknown 12 (4.9%).
Results : Transient elastography was correlated with APRI (r=0.712) and the grades of esophageal varices (r=0.635). The AUROC values of transient elastography were 0.916 (95% CI: 0.838-0.954) for the presence of esophageal varices, 0.875 (95% CI: 0.819-0.931) for the esophageal varices grade ≥2, and 0.895 (95% CI: 0.846-0.945) for esophageal variceal hemorrhage. The cutoff values for 90% specificity were 15.3 kPa for esophageal varices, 20.7 kPa for esophageal varices grade ≥2 and 34.8 kPa for esophageal variceal hemorrhage, while the negative predictive values were 90%, 94% and 97%, respectively.
Conclusions : Transient elastography was correlated with the presence of esophageal varices, the grades of esophageal varices and the presence of esophageal variceal hemorrhage. Therefore, this data may help to screen those patients how might undergo upper gastrointestinal endoscopy. (Korean J Med 74:491-499, 2008)

영어초록

Background/Aims : This study was conducted to evaluate the efficacy of transient elastography (FibroscanⓇ) for predicting esophageal varices and esophageal variceal hemorrhage in patients with chronic liver diseases.
Methods : We studied 245 patients (mean age: 50.1 years, male/female: 181/64) with chronic liver diseases to determine the relation between the clinical or serologic markers associated with liver fibrosis and tissue elastography, and these tests were performed in Feb 2007. The causes of chronic liver diseases were hepatitis B virus in 139 (56.7%), hepatitis C virus in 30 (12.2%), alcohol in 38 (15.5%), nonalcoholic fatty liver disease in 23 (9.4%), autoimmune liver disease in 3 (1.2%), and unknown 12 (4.9%).
Results : Transient elastography was correlated with APRI (r=0.712) and the grades of esophageal varices (r=0.635). The AUROC values of transient elastography were 0.916 (95% CI: 0.838-0.954) for the presence of esophageal varices, 0.875 (95% CI: 0.819-0.931) for the esophageal varices grade ≥2, and 0.895 (95% CI: 0.846-0.945) for esophageal variceal hemorrhage. The cutoff values for 90% specificity were 15.3 kPa for esophageal varices, 20.7 kPa for esophageal varices grade ≥2 and 34.8 kPa for esophageal variceal hemorrhage, while the negative predictive values were 90%, 94% and 97%, respectively.
Conclusions : Transient elastography was correlated with the presence of esophageal varices, the grades of esophageal varices and the presence of esophageal variceal hemorrhage. Therefore, this data may help to screen those patients how might undergo upper gastrointestinal endoscopy. (Korean J Med 74:491-499, 2008)

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