Department of Gastroenterology, Yijishan Hospital of Wannan Medical College, Wuhu, China.
Department of Gastroenterology, Fuyang Second People's Hospital, Fuyang, China.
Ann Med. 2024 Dec;56(1):2400315. doi: 10.1080/07853890.2024.2400315. Epub 2024 Sep 6.
Endoscopic variceal ligation (EVL) is the primary treatment for esophageal variceal bleeding in patients with liver cirrhosis (LC). Postoperative rebleeding is a complication of EVL, contributing to over 20% of bleeding-related deaths. This study aims to examine the association between platelet-to-lymphocyte ratio (PLR) and rebleeding within 6 weeks after EVL in patients with LC.
The study included 145 eligible patients who underwent their first EVL procedure at Yijishan Hospital of Wannan Medical College between January 2016 and August 2022 (YJS cohort). An external validation cohort comprising 338 eligible patients from NO.2 People's Hospital of Fuyang City (FY cohort) between July 2018 and August 2022 was also utilized.
In the YJS cohort, Multivariate logistic analysis indicated that high PLR is independently associated with early rebleeding after EVL. The restricted cubic spline analysis demonstrated that the risk of rebleeding increases with rising PLR, stabilizing at PLR values greater than 150. Similar findings were validated in the FY cohort.
Our results have the potential to aid in the identification of high-risk patients for early rebleeding after EVL, thereby enabling improved clinical management and outcomes for these individuals.
内镜下食管静脉曲张套扎术（EVL）是肝硬化（LC）患者食管静脉曲张出血的主要治疗方法。术后再出血是 EVL 的一种并发症，导致超过 20%的出血相关死亡。本研究旨在探讨血小板与淋巴细胞比值（PLR）与 LC 患者 EVL 后 6 周内再出血之间的关系。
本研究纳入了 2016 年 1 月至 2022 年 8 月在皖南医学院弋矶山医院进行首次 EVL 治疗的 145 例符合条件的患者（YJS 队列）。还利用了 2018 年 7 月至 2022 年 8 月在阜阳市第二人民医院（FY 队列）的 338 例符合条件的患者的外部验证队列。
在 YJS 队列中，多变量逻辑分析表明，高 PLR 与 EVL 后早期再出血独立相关。限制性立方样条分析表明，随着 PLR 的升高，再出血的风险增加，在 PLR 值大于 150 时趋于稳定。FY 队列也验证了类似的发现。
我们的研究结果有可能帮助识别 EVL 后早期再出血的高危患者，从而改善这些患者的临床管理和预后。
