Department of Gastroenterology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang City, Hubei Province, P.R.C.
Department of Infectious Diseases, Ankang Central Hospital, Hubei University of Medicine, Ankang City, Shanxi Province, P.R.C.
PLoS One. 2021 Dec 2;16(12):e0260774. doi: 10.1371/journal.pone.0260774. eCollection 2021.
BACKGROUND & AIMS: Platelet count/spleen longest diameter ratio (PSDR) is widely used in clinical practice due to its good performance in predicting esophageal varices (EV). We obtained spleen volume (SV) by magnetic resonance examination, the purpose of this study was to evaluate the clinical value of platelet count/spleen volume ratio (PSVR) and spleen volume in predicting EV in patients with hepatitis B cirrhosis. Methods: This study was a diagnostic accuracy experiment and retrospective, 199 patients with hepatitis B cirrhosis who met the criteria were selected as the research subjects. All patients were collected blood samples in the morning on an empty stomach within 2 days, and related indicators were tested. Within 10 days, they received electronic gastroscopy and abdominal magnetic resonance examination. According to the Child-Pugh score, the patients were divided into groups with or without EV and with or without high-risk esophageal varices (HRV), then statistical analysis of the two groups was performed.
The area under the curve (AUC) of PSVR in predicting EV or HRV in each group (85.5%-92.6%) was higher than PSDR, SV, spleen diameter, and platelet count. The AUC of PSDR in diagnosing HRV was higher than SV, and the AUC of SV in diagnosing EV was higher than PSDR, but the difference was not significant (P>0.05). In Child-Pugh A patients, Multivariate logistic regression analysis showed PSVR could be a predictor of HRV (P<0.05), SV was a reliable predictor of EV (P<0.05).
PSVR is better than PSDR, spleen diameter, platelet count in predicting EV; in the absence of serological results, SV could be used instead of PSDR. Both can predict EV or HRV of patients with hepatitis B cirrhosis.
血小板计数/脾脏最长径比值（PSDR）在预测食管静脉曲张（EV）方面表现良好，因此在临床实践中得到广泛应用。我们通过磁共振检查获得脾脏体积（SV），本研究旨在评估血小板计数/脾脏体积比值（PSVR）和脾脏体积预测乙型肝炎肝硬化患者 EV 的临床价值。方法：本研究为诊断准确性实验，回顾性研究，选择符合标准的 199 例乙型肝炎肝硬化患者作为研究对象。所有患者均在空腹状态下于 2 天内的早晨采集血样，并检测相关指标。在 10 天内，他们接受电子胃镜和腹部磁共振检查。根据 Child-Pugh 评分，将患者分为有无 EV 组和有无高危食管静脉曲张（HRV）组，然后对两组进行统计学分析。结果：PSVR 预测各组 EV 或 HRV 的曲线下面积（AUC）（85.5%-92.6%）均高于 PSDR、SV、脾脏直径和血小板计数。PSDR 诊断 HRV 的 AUC 高于 SV，SV 诊断 EV 的 AUC 高于 PSDR，但差异无统计学意义（P>0.05）。在 Child-Pugh A 患者中，多变量逻辑回归分析显示 PSVR 可预测 HRV（P<0.05），SV 是预测 EV 的可靠指标（P<0.05）。结论：PSVR 优于 PSDR、脾脏直径和血小板计数，可预测 EV；在缺乏血清学结果的情况下，SV 可替代 PSDR。两者均可预测乙型肝炎肝硬化患者的 EV 或 HRV。
