González-Ojeda Alejandro, Cervantes-Guevara Gabino, Chávez-Sánchez Manuela, Dávalos-Cobián Carlos, Ornelas-Cázares Susana, Macías-Amezcua Michel Dassaejv, Chávez-Tostado Mariana, Ramírez-Campos Kenia Militzi, Ramírez-Arce Anaís Del Rocío, Fuentes-Orozco Clotilde
Alejandro González-Ojeda, Michel Dassaejv Macías-Amezcua, Mariana Chávez-Tostado, Kenia Militzi Ramírez-Campos, Anaís del Rocío Ramírez-Arce, Clotilde Fuentes-Orozco, Research Unit in Clinical Epidemiology, Specialties Hospital of the Western Medical Center, Medical Unit of High Specialty, Mexican Institute of Social Security, Guadalajara, CP 44340, Jalisco, México.
World J Gastroenterol. 2014 Feb 28;20(8):2079-84. doi: 10.3748/wjg.v20.i8.2079.
To validate whether the platelet count/spleen size ratio can be used to predict the presence of esophageal varices in Mexican patients with hepatic cirrhosis.
This was an analytical cross-sectional study to validate the diagnostic test for hepatic cirrhosis and was performed between February 2010 and December 2011. Patients with a diagnosis of hepatic cirrhosis were included and stratified using their Child-Pugh score. Biochemical parameters were evaluated, and ultrasound was used to measure the longest diameter of the spleen. The platelet count/spleen diameter ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices. Upper gastrointestinal endoscopy was used as the gold standard. Sensitivity and specificity, positive and negative predictive values, and positive and negative likelihood ratios were determined, with the cutoff points determined by receiver-operating characteristic curves.
A total of 91 patients were included. The mean age was 53.75 ± 12 years; 50 (54.9%) were men, and 41 (45.0%) women. The etiology of cirrhosis included alcohol in 48 (52.7%), virally induced in 24 (26.3%), alcoholism plus hepatitis C virus in three (3.2%), cryptogenic in nine (9.8%), and primary biliary cirrhosis in seven (7.6%). Esophageal varices were present in 73 (80.2%) patients. Child-Pugh classification, 17 (18.6%) patients were classified as class A, 37 (40.6%) as class B, and 37 (40.6%) as class C. The platelet count/spleen diameter ratio to detect esophageal varices independent of the grade showed using a cutoff value of ≤ 884.3, had 84% sensitivity, 70% specificity, and positive and negative predictive values of 94% and 40%, respectively.
Our results suggest that the platelet count/spleen diameter ratio may be a useful tool for detecting esophageal varices in patients with hepatic cirrhosis.
验证血小板计数/脾脏大小比值是否可用于预测墨西哥肝硬化患者食管静脉曲张的存在。
这是一项分析性横断面研究，旨在验证肝硬化的诊断试验，于2010年2月至2011年12月进行。纳入诊断为肝硬化的患者，并根据其Child-Pugh评分进行分层。评估生化参数，并使用超声测量脾脏的最长直径。计算并分析血小板计数/脾脏直径比值，以确定其是否可预测食管静脉曲张的存在。上消化道内镜检查用作金标准。确定敏感性和特异性、阳性和阴性预测值以及阳性和阴性似然比，截断点由受试者操作特征曲线确定。
共纳入91例患者。平均年龄为53.75±12岁；50例（54.9%）为男性，41例（45.0%）为女性。肝硬化的病因包括酒精性48例（52.7%）、病毒感染性24例（26.3%）、酒精性加丙型肝炎病毒感染3例（3.2%）、隐源性9例（9.8%）和原发性胆汁性肝硬化7例（7.6%）。73例（80.2%）患者存在食管静脉曲张。Child-Pugh分级中，17例（18.6%）患者为A级，37例（40.6%）为B级，37例（40.6%）为C级。血小板计数/脾脏直径比值检测食管静脉曲张，与分级无关，使用截断值≤884.3时，敏感性为84%，特异性为70%，阳性和阴性预测值分别为94%和40%。
我们的结果表明，血小板计数/脾脏直径比值可能是检测肝硬化患者食管静脉曲张的有用工具。
