Ozdil Kamil, Ozturk Oguzhan, Calık Ecem Sevim, Akbas Eyup Sami, Kanat Evren, Calıskan Zuhal, Demirdag Hakan, Kahraman Resul, Bulur Atilla, Bilgic Nermin Mutlu, Doganay Levent, Sokmen Hacı Mehmet
Gastroenterology Clinic, Umraniye Training and Research Hospital, Istanbul, Turkey.
Internal Medicine Clinic, Umraniye Training and Research Hospital, Istanbul, Turkey.
North Clin Istanb. 2016 Jun 7;3(1):46-52. doi: 10.14744/nci.2016.60362. eCollection 2016.
This study investigated the relationship between size of gastroesophageal varices and platelet count/spleen diameter ratio in cirrhotic patients.
The present study included 186 cirrhotic patients in whom gastroesophageal varices were seen during upper gastrointestinal system endoscopy. Clinical features, laboratory parameters, upper gastrointestinal system endoscopy, and abdominal ultrasonographic findings of patients were evaluated retrospectively. Platelet count/spleen diameter ratio (P/S) was calculated by dividing number of platelets in complete blood count (CBC) to largest diameter of spleen. Varices were classified as small, medium, or large, and patients were separated into two groups for comparison: those with small varices and those with medium or large varices. Of the total, 66.7 % of the patients were men (n=124) and 33.3% were women (n=62). Esophageal varices were found in 82.7% and gastric varices were found in 17.3%.
Patients with large esophageal varices were found to have significantly lower P/S compared to patients with small esophageal varices (p=0.04). In receiver operating characteristic (ROC) curve analysis, P/S and large varices correlated with 82% sensitivity and 79% positive predictive value. However, no statistically significant correlation between size of varices and P/S was found in patients with gastric varices (p=0.78).
In patients with esophageal varices, P/S was found to be correlated with large varices with 82% sensitivity. However, this ratio did not predict large varices in patients with gastric varices. Prospective and randomized clinical researches are needed to clarify our findings.
本研究调查肝硬化患者胃食管静脉曲张大小与血小板计数/脾直径比值之间的关系。
本研究纳入186例在进行上消化道系统内镜检查时发现有胃食管静脉曲张的肝硬化患者。对患者的临床特征、实验室参数、上消化道系统内镜检查及腹部超声检查结果进行回顾性评估。血小板计数/脾直径比值（P/S）通过全血细胞计数（CBC）中的血小板数量除以脾脏最大直径来计算。静脉曲张分为小、中、大三类，患者分为两组进行比较：小静脉曲张组和中或大静脉曲张组。患者中男性占66.7%（n = 124），女性占33.3%（n = 62）。发现食管静脉曲张的患者占82.7%，胃静脉曲张的患者占17.3%。
发现大食管静脉曲张患者的P/S显著低于小食管静脉曲张患者（p = 0.04）。在受试者工作特征（ROC）曲线分析中，P/S与大静脉曲张的相关性为灵敏度82%，阳性预测值79%。然而，胃静脉曲张患者的静脉曲张大小与P/S之间未发现统计学显著相关性（p = 0.78）。
在食管静脉曲张患者中，发现P/S与大静脉曲张相关，灵敏度为82%。然而，该比值不能预测胃静脉曲张患者的大静脉曲张情况。需要进行前瞻性随机临床研究以阐明我们的研究结果。
