Clinic of Gastroenterology and Hepatology, Clinical Center of Serbia, 11000 Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Medicina (Kaunas). 2022 Jan 20;58(2):158. doi: 10.3390/medicina58020158.
: Upper endoscopy is considered the gold standard for screening and diagnosis of esophageal varices (EV). Non-invasive methods for predicting EV have become a research hotspot in recent years. The aim of this study was to assess the role of non-invasive scores in predicting the presence of EV in patients with liver cirrhosis, and to determine the value of these scores in predicting the outcome of patients with cirrhosis presenting with acute variceal bleeding. : A total of 386 patients with liver cirrhosis were included. The model for end-stage liver disease (MELD), aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT), AST to platelet ratio index (APRI), fibrosis-4-index (FIB-4), fibrosis index (FI), King's Score, albumin-bilirubin (ALBI) score, and platelet-albumin-bilirubin (PALBI) score were calculated. The discriminatory capacities of the examined scores in predicting the presence of esophageal varices were tested using receiver operating characteristic (ROC) curves. : The ROC curve analysis showed (area under the curve) AUC values of ALBI and PALBI of 0.603, and 0.606, respectively, for the prediction of EV. APRI, MELD, PALBI, King's, FIB-4, and ALBI scores showed statistically significant correlation with EV bleeding ( < 0.05). AUC of APRI and MELD for predicting EV bleeding were 0.662 and 0.637, respectively. The AUC value of MELD in short-term mortality was 0.761. : ALBI and PALBI scores had modest diagnostic accuracy of EVs in liver cirrhosis. APRI and MELD can be used as a reference index for the EV bleeding, and MELD score is best associated with short-term outcome in cirrhotic patients.
上消化道内镜检查被认为是筛查和诊断食管静脉曲张(EV)的金标准。近年来,预测 EV 的非侵入性方法已成为研究热点。本研究旨在评估非侵入性评分在预测肝硬化患者 EV 存在中的作用,并确定这些评分在预测肝硬化急性静脉曲张出血患者预后中的价值。
共纳入 386 例肝硬化患者。计算终末期肝病模型(MELD)、天冬氨酸氨基转移酶(AST)/丙氨酸氨基转移酶(ALT)比值(AST/ALT)、AST 血小板比值指数(APRI)、纤维化-4 指数(FIB-4)、纤维化指数(FI)、King 评分、白蛋白-胆红素(ALBI)评分和血小板-白蛋白-胆红素(PALBI)评分。使用受试者工作特征(ROC)曲线测试所检查评分预测食管静脉曲张存在的判别能力。
ROC 曲线分析显示,ALBI 和 PALBI 预测 EV 的 AUC 值分别为 0.603 和 0.606。APRI、MELD、PALBI、King 评分、FIB-4 和 ALBI 评分与 EV 出血呈统计学显著相关(<0.05)。APRI 和 MELD 预测 EV 出血的 AUC 值分别为 0.662 和 0.637。MELD 评分对短期死亡率的 AUC 值为 0.761。
ALBI 和 PALBI 评分对肝硬化患者 EV 具有中等诊断准确性。APRI 和 MELD 可作为 EV 出血的参考指标,MELD 评分与肝硬化患者的短期预后相关性最好。