Alempijevic Tamara, Bulat Vladislava, Djuranovic Srdjan, Kovacevic Nada, Jesic Rada, Tomic Dragan, Krstic Slobodan, Krstic Miodrag
Clinical Centre of Serbia, Institute for Digestive Diseases, Clinic for Gastroenterology and Hepatology, 6 Dr Koste Todorovica St. 11000 Belgrade, Serbia.
World J Gastroenterol. 2007 Oct 28;13(40):5331-5. doi: 10.3748/wjg.v13.i40.5331.
To study the value of biochemical and ultraso-nographic parameters in prediction of presence and size of esophageal varices.
The study includes selected cirrhotic patients who underwent a complete biochemical workup, upper digestive endoscopic and ultrasonographic examinations. Albumin/right liver lobe diameter and platelet count/spleen diameter ratios were calculated. The correlation between calculated ratio and the presence and degree of esophageal varices was evaluated.
Ninety-four subjects (62 males, 32 females), with a mean age of 52.32 +/- 13.60 years, were studied. Child-Pugh class A accounted for 42.6%, class B 37.2%, whereas class C 20.2%. Esophageal varices (OE) were not demonstrated by upper digestive endoscopy in 24.5%, while OE grade I was found in 22.3% patients, grade II in 33.0%, grade III in 16.0%, and grade IV in 4.3%. The mean value of right liver lobe diameter/albumin ratio was 5.51 +/- 1.82 (range from 2.76 to 11.44), while the mean platelet count/spleen diameter ratio was 1017.75 +/- 729.36 (range from 117.39 to 3362.50), respectively. Statistically significant correlation was proved by Spearman's test between OE grade and calculated ratios. The P values were 0.481 and -0.686, respectively.
The right liver lobe diameter/albumin and platelet count/spleen diameter ratios are non-invasive parameters providing accurate information pertinent to determination of presence of esophageal varices, and their grading in patients with liver cirrhosis.
研究生化及超声参数在预测食管静脉曲张的存在及大小方面的价值。
本研究纳入了接受全面生化检查、上消化道内镜检查及超声检查的肝硬化患者。计算白蛋白/右肝叶直径及血小板计数/脾直径比值。评估计算所得比值与食管静脉曲张的存在及程度之间的相关性。
共研究了94名受试者（62名男性，32名女性），平均年龄为52.32±13.60岁。Child-Pugh A级占42.6%，B级占37.2%，C级占20.2%。上消化道内镜检查未发现食管静脉曲张（OE）的患者占24.5%，而发现OE I级的患者占22.3%，II级占33.0%，III级占16.0%，IV级占4.3%。右肝叶直径/白蛋白比值的平均值为5.51±1.82（范围为2.76至11.44），而血小板计数/脾直径比值的平均值分别为1017.75±729.36（范围为117.39至3362.50）。Spearman检验证明OE分级与计算所得比值之间存在统计学显著相关性。P值分别为0.481和 -0.686。
右肝叶直径/白蛋白及血小板计数/脾直径比值是无创参数，可为肝硬化患者食管静脉曲张的存在及其分级的确定提供准确信息。
