Liu Bingju, Wu Lichun, Wang Guangchuan, Feng Hua, Hu Jinhua, Cui Yi, Zhang Chunqing
Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China.
Zhonghua Gan Zang Bing Za Zhi. 2015 Jan;23(1):50-4. doi: 10.3760/cma.j.issn.1007-3418.2015.01.012.
To investigate the predictive value of hepatic venous pressure gradient (HVPG) for early bleeding after esophageal variceal ligation (EVL) by analyzing the differences in HVPG in patients with and without post-EVL bleeding.
The medical records of patients who had been diagnosed with cirrhosis and esophageal varices and who had pre-EVL HVPG measurement data were surveyed. The study population included 105 patients from October 2010 to March 2014. Data of HVPG value, previous treatment history, endoscopic manifestation, and whether bleeding and serious complications occurred within 2 weeks after the ligation procedure were investigated as independent risk factors.
included the chi-square test and Wilcoxon test, logistic regression modeling and receiver operating characteristic (ROC) analysis using the SPSS software version 16.
Only HVPG value was identified as an independent risk factor of early bleeding after EVL.According to the ROC analysis, the area under the curve (AUC) of HVPG for early bleeding after EVL was 0.866; when HVPG was more than or equal to 16 mmHg, AUC was 0.838. The sensitivity was 90.9% and the specificity was 76.4%.
HVPG is an independent factor of early bleeding after EVL and when HVPG cut-off value of more than or equal to 16 mmHg is used the predictive ability has certain accuracy and high sensitivity and specificity.
通过分析食管静脉曲张结扎术（EVL）后出血和未出血患者肝静脉压力梯度（HVPG）的差异，探讨HVPG对EVL术后早期出血的预测价值。
调查已诊断为肝硬化和食管静脉曲张且有EVL术前HVPG测量数据的患者的病历。研究人群包括2010年10月至2014年3月的105例患者。将HVPG值、既往治疗史、内镜表现以及结扎术后2周内是否发生出血和严重并发症的数据作为独立危险因素进行调查。
采用SPSS 16.0软件进行卡方检验、Wilcoxon检验、逻辑回归建模和受试者工作特征（ROC）分析。
仅HVPG值被确定为EVL术后早期出血的独立危险因素。根据ROC分析，EVL术后早期出血的HVPG曲线下面积（AUC）为0.866；当HVPG大于或等于16 mmHg时，AUC为0.838。敏感性为90.9%，特异性为76.4%。
HVPG是EVL术后早期出血的独立因素，当采用大于或等于16 mmHg的HVPG截断值时，预测能力具有一定的准确性，且敏感性和特异性较高。
