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血小板参数及其相关评分系统在预测肝硬化患者食管胃静脉曲张及侧支循环中的价值。

The value of platelet parameters and related scoring system in predicting esophageal varices and collateral veins in patients with liver cirrhosis.

机构信息

Department of Chronic Liver Disease, Tianjin Second People's Hospital, China.

The Third Central Hospital of Tianjin, Tianjin, China.

出版信息

J Clin Lab Anal. 2021 Mar;35(3):e23694. doi: 10.1002/jcla.23694. Epub 2021 Jan 2.

Abstract

OBJECTIVE

To explore the value of platelet parameters and related scoring system in predicting esophageal varices and collateral veins in patients with liver cirrhosis.

METHOD

A total of 94 patients with liver cirrhosis diagnosed in our hospital from March 2017 to July 2018 were divided into without esophageal varices group (NEV) and esophageal varices group (EV) into mild, moderate, and severe subgroups according to the results of general gastroscopy. The differences of biological indexes among different degrees of esophageal varices and collateral veins were analyzed, and the related factors of esophageal varices and collateral veins were analyzed.

RESULTS

PLT count and PCT decreased gradually with the increase of esophageal varices in EV group. There were significant differences in PLT count and PCT, which were negatively correlated with the degree of collateral vein in esophageal collateral vein group. The maximum cross-sectional diameter and mean diameter of esophageal collateral veins in EV group were wider than those in NEV group. Further study showed that the maximum cross-sectional total diameter and mean diameter of esophageal collateral veins in severe esophageal varices group were wider than those in NEV group and mild esophageal varices group. Sequential Logistic regression analysis showed that PCT could effectively predict the existence of esophageal varices. Platelet parameters had no significant diagnostic value in predicting peri-ECV and Para-ECV. For platelet-related FI, APRI, FIB-4, King, Lok, GUCI, and FibroQ scoring systems, multivariate Logistic regression showed that FI, FIB-4, Lok and FibroQ scoring systems could effectively predict the presence of EV and Para-ECV (P<0.05), and its Lok Index is better than other rating systems, with AUROC values of 0.773 and 0.747, respectively. There is no significant predictive value for above scoring systems of peri-ECV.

CONCLUSIONS

PCT and LOK index can effectively predict the existence of esophageal varices and para-esophageal veins in patients with liver cirrhosis, and can be used as an effective filling method for common gastroscopy and endoscopic ultrasonography to detect EV and ECV in liver cirrhosis.

摘要

目的

探讨血小板参数及相关评分系统在预测肝硬化患者食管静脉曲张及侧支静脉中的价值。

方法

选取 2017 年 3 月至 2018 年 7 月我院收治的 94 例肝硬化患者,根据普通胃镜检查结果分为无食管静脉曲张组(NEV)和食管静脉曲张组(EV),并根据静脉曲张程度分为轻度、中度和重度亚组。分析不同程度食管静脉曲张和侧支静脉患者的生物学指标差异,并分析食管静脉曲张和侧支静脉的相关因素。

结果

EV 组血小板计数(PLT)和血小板压积(PCT)随食管静脉曲张程度的增加而逐渐降低,PLT 计数和 PCT 差异有统计学意义,且与食管侧支静脉程度呈负相关。EV 组食管侧支静脉最大横截面积及平均直径均大于 NEV 组。进一步研究显示,重度食管静脉曲张组食管侧支静脉最大横截面积总直径及平均直径大于 NEV 组和轻度食管静脉曲张组。序贯 Logistic 回归分析显示 PCT 可有效预测食管静脉曲张的存在。血小板参数对预测食管旁侧支静脉和胃冠状静脉无明显诊断价值。对于与血小板相关的 FI、APRI、FIB-4、King、Lok、GUCI 和 FibroQ 评分系统,多变量 Logistic 回归显示 FI、FIB-4、Lok 和 FibroQ 评分系统可有效预测 EV 和 Para-ECV 的存在(P<0.05),且其 Lok 指数优于其他评分系统,其 AUROC 值分别为 0.773 和 0.747。上述评分系统对食管旁侧支静脉无明显预测价值。

结论

PCT 和 Lok 指数可有效预测肝硬化患者食管静脉曲张和食管旁静脉的存在,可作为普通胃镜和内镜超声检查的有效补充方法,用于检测肝硬化患者的 EV 和 ECV。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7293/7957998/969e394af74d/JCLA-35-e23694-g001.jpg

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