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肝硬化患儿食管静脉曲张的非侵入性标志物

Noninvasive markers for esophageal varices in children with cirrhosis.

作者信息

Rahmani Parisa, Farahmand Fatemeh, Heidari Ghobad, Sayarifard Azadeh

机构信息

Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad.

出版信息

Clin Exp Pediatr. 2021 Jan;64(1):31-36. doi: 10.3345/cep.2019.01599. Epub 2020 Jul 21.

Abstract

BACKGROUND

The diagnosis of esophageal varices (EV) is based on the findings of esophagogastroduodenoscopy (EGD), biopsy, and serum markers. Thus, noninvasive cost-effective tests through which high-risk EV children can be diagnosed are needed.

PURPOSE

This cross-sectional study aimed to identify the noninvasive markers for EV in children with liver cirrhosis.

METHODS

A total of 98 children with liver cirrhosis were evaluated in this study. The spleen size, platelet count, serum albumin, liver function test results, and risk scores were evaluated prior to endoscopy. The endoscopic investigations aimed to identify the presence of EV and red signs, and determine varices sizes.

RESULTS

Endoscopy revealed varices in 43 subjects (43.9%). The spleen size, platelet count, international normalized ratio, aspartate aminotransferase to platelet ratio index (APRI), platelet count to spleen size ratio, and risk score differed significantly between patients with and without EV on univariate analysis; however, the logistic regression analysis showed no differences, indicating that none of these parameters were independently associated with the presence of EV.

CONCLUSION

Platelet count, risk score, platelet count to spleen size, and APRI can be useful tools for the identification of highrisk patients with EV and might reduce the need for invasive methods like EGD.

摘要

背景

食管静脉曲张(EV)的诊断基于食管胃十二指肠镜检查(EGD)、活检和血清标志物的检查结果。因此,需要通过非侵入性且具有成本效益的检测方法来诊断高危EV儿童。

目的

这项横断面研究旨在确定肝硬化儿童中EV的非侵入性标志物。

方法

本研究共评估了98例肝硬化儿童。在内镜检查前评估脾脏大小、血小板计数、血清白蛋白、肝功能检查结果和风险评分。内镜检查旨在确定是否存在EV和红色征,并确定静脉曲张大小。

结果

内镜检查发现43例(43.9%)有静脉曲张。单因素分析显示,有和没有EV的患者之间,脾脏大小、血小板计数、国际标准化比值、天冬氨酸氨基转移酶与血小板比值指数(APRI)、血小板计数与脾脏大小比值以及风险评分存在显著差异;然而,逻辑回归分析显示无差异,表明这些参数均与EV的存在无独立相关性。

结论

血小板计数、风险评分、血小板计数与脾脏大小比值以及APRI可作为识别高危EV患者的有用工具,可能会减少对EGD等侵入性方法的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/150d/7806413/cbe9c59b186c/cep-2019-01599f1.jpg

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