肝硬化患者食管静脉曲张的预测因素研究

Prediction of esophageal varices in cirrhotic patients using non-invasive methods

[目的]运用非侵入性方法分析初治的肝硬化患者食管静脉曲张(EV)的预测因素。[方法]收集160例初治的肝硬化患者的临床、实验室、影像学检查以及胃镜检查结果,分别应用单因素分析和多因素Logistic回归分析,得出预测EV的独立危险因素,再对所得的独立危险因素予以ROC分析,以期求出各自的cut-off值,用于区分高危组和低危组人群。[结果]有EV121例,包括轻度39例,中度36例,重度46例,无EV(NEV)39例。分别按有无EV及EV程度进行分组,行Logistic多因素回归分析得知,血小板/脾脏长径和门静脉血流速度即为预测有无EV的独立危险因素,又为预测EV程度的独立危险因素。[结论]肝硬化患者EV程度与门静脉高压程度平行。血小板/脾脏长径、门静脉血流速度可用于肝硬化EV及其程度的预测。

[Objective] To analyze the independent risk factors which might predict the presence of esophageal varices in cirrhotic patients with non-invasive.methods.[Methods] One hundred and sixty cirrhotic patients were included.Endoscopy was performed in all patients.All of their clinical,biochemical,radiographic inspection and endoscopic appearance were collected.All data were analyzed by univariate and multivariate analysis respectively.After the independent risk factors were obtained,ROC analysis was used to evaluate their predictive efficacy.The cut-offs with the best sensitivity and specificity were used to discriminate the high-risk group and low-risk group.[Rsults] In this study,46 patients had large esophageal varices,36 patients had medium esophageal varices,39 patients had small esophageal varices,and 39 patients had no oesophageal varices.Platelet count/spleen length and portal venous flow velocity were independent risk factors in the prediction of esophageal varices as well as the degree of esophageal varices.[Conclusion] Platelet count/spleen length and portal venous flow velocity can be used to predict esophageal varices and also the degree of esophageal varices in cirrhotic patients.