Department of Digestive Health and Diseases, Government Peripheral Hospital, Kilpauk Medical College, Chennai - 102, India.
Saudi J Gastroenterol. 2010 Jan-Mar;16(1):38-42. doi: 10.4103/1319-3767.58767.
BACKGROUND/AIM: Esophageal varices (EVs) are a serious consequence of portal hypertension in patients with liver diseases. Several studies have evaluated possible noninvasive markers of EVs to reduce the number of unnecessary endoscopies in patients with cirrhosis but without varices. This prospective study was conducted to evaluate noninvasive predictors of large varices (LV).
The study analyzed 106 patients with liver diseases from January 2007 to March 2008. Relevant clinical parameters assessed included Child-Pugh class, ascites and splenomegaly. Laboratory parameters like hemoglobin level, platelet count, prothrombin time, serum bilirubin, albumin and ultrasonographic characteristics like splenic size, splenic vein size, portal vein diameter were assessed. Univariate and multivariate analysis was done on the data for predictors of large EVs.
Incidence of large varices was seen in 41%. On multivariate analysis, independent predictors for the presence of LV were palpable spleen, low platelet count, spleen size> 13.8 mm, portal vein> 13 mm, splenic vein> 11.5 mm. The receiver operating characteristic (ROC) curve showed 0.883 area under curve. Platelet spleen diameter ratio 909 had a sensitivity and specificity of 88.5%, 83% respectively.
Thrombocytopenia, large spleen size, portal vein size and platelet spleen diameter ratio strongly predicts large number of EVs.
背景/目的：食管静脉曲张（EVs）是肝病患者门脉高压的严重后果。有几项研究评估了可能的非侵入性 EV 标志物，以减少无静脉曲张的肝硬化患者不必要的内镜检查次数。本前瞻性研究旨在评估大静脉曲张（LV）的非侵入性预测因子。
本研究分析了 2007 年 1 月至 2008 年 3 月期间 106 例肝病患者。评估的相关临床参数包括 Child-Pugh 分级、腹水和脾肿大。评估的实验室参数包括血红蛋白水平、血小板计数、凝血酶原时间、血清胆红素、白蛋白和超声特征，如脾脏大小、脾静脉大小、门静脉直径。对数据进行单因素和多因素分析，以确定大 EV 的预测因子。
大静脉曲张的发生率为 41%。多因素分析显示，LV 存在的独立预测因子为可触及的脾脏、血小板计数低、脾脏大小>13.8mm、门静脉>13mm、脾静脉>11.5mm。受试者工作特征（ROC）曲线显示曲线下面积为 0.883。血小板脾直径比 909 的敏感性和特异性分别为 88.5%和 83%。
血小板减少症、大脾脏大小、门静脉大小和血小板脾直径比强烈预测大量 EV 的存在。
