Mathur Navgeet, Patel Harsh, Mangalia Ravi, Mehta Amit, Mathur Medha, Verma Anjana, Patyal Ashish
Department of General Medicine, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.
Department of General Medicine, GMERS Medical College and Hospital, Sola, Ahmedabad, Gujarat, India.
J Family Med Prim Care. 2024 Apr;13(4):1347-1353. doi: 10.4103/jfmpc.jfmpc_702_23. Epub 2024 Apr 22.
Development of esophageal varices is one of the major complications of liver cirrhosis, and endoscopy is used to see the presence, grading, and long-term monitoring of esophageal varices which is an invasive and unpleasant procedure. There is no adequate data available showing noninvasive methods can be used for the same.
Seventy patients with liver cirrhosis participated in the study. Factors like portal vein diameter, spleen size, platelet count, serum bilirubin, Child-Pugh score, prothrombin time (PT), and PT INR were observed and correlated endoscopically with the presence and grading of esophageal varices in all patients.
The platelet count, portal vein diameter, serum bilirubin, spleen bipolar diameter, and PT had statistically significant correlations with the presence of varices. Among them, platelet count, portal vein diameter, and serum bilirubin also had statistically significant correlations with the grading of varices. Monitoring of these noninvasive parameters can help in monitoring variceal growth.
Noninvasive parameters can be used effectively to predict the presence and grading of esophageal varices and at the same time keep the rate of undiagnosed varices acceptably low. By using noninvasive parameters, patients can be benefited by decreasing the requirement of repeated endoscopic evaluation which is an unpleasant procedure and availability is also limited.
食管静脉曲张的发生是肝硬化的主要并发症之一,内镜检查用于观察食管静脉曲张的存在、分级及长期监测,这是一种侵入性且令人不适的检查方法。目前尚无充分数据表明非侵入性方法可用于同样目的。
70例肝硬化患者参与了本研究。观察门静脉直径、脾脏大小、血小板计数、血清胆红素、Child-Pugh评分、凝血酶原时间(PT)及PT国际标准化比值(INR)等因素,并在内镜下与所有患者食管静脉曲张的存在及分级进行相关性分析。
血小板计数、门静脉直径、血清胆红素、脾脏两极直径及PT与静脉曲张的存在具有统计学显著相关性。其中,血小板计数、门静脉直径及血清胆红素与静脉曲张的分级也具有统计学显著相关性。监测这些非侵入性参数有助于监测静脉曲张的发展。
非侵入性参数可有效用于预测食管静脉曲张的存在及分级,同时使未诊断出的静脉曲张发生率保持在可接受的低水平。通过使用非侵入性参数,可减少重复内镜评估的需求,从而使患者受益,因为内镜评估是一种令人不适的检查且其可用性也有限。