PC、SD、PC/SD、FIB-4对肝硬化食管静脉曲张的诊断价值

Diagnostic value of PC,SD,PC/SD and FIB-4 in cirrhotic esophageal varices

目的:评估脾长径(SD)、血小板计数(PC)、血小板计数/脾长径比值(PC/SD)、FIB-4指数预测肝硬化食管静脉曲张(esophageal varices,EV)的临床价值。方法:收集134例肝硬化病人的临床资料,均行胃镜检查明确食管胃底静脉曲张情况,按有无EV分为EV组及非EV组,EV组病人按照是否合并红色征(RC)分为RC(+)组及RC(-)组,评价PC、SD、PC/SD、FIB-4等四项指标对EV的诊断效能及分析RC的影响因素。结果:EV组PC、白细胞计数、PC/SD均低于非EV组,SD、FIB-4、Child-Pugh评分、凝血酶原时间均高于非EV组,差异有统计学意义(P<0.05~P<0.01);PC、SD、PC/SD、FIB-4对EV预测的受试者工作曲线下面积分别为0.781、0.811、0.811、0.715;SD、PC/SD联合对于EV预测的曲线下面积为0.822,灵敏度为85.4%,特异度为71.1%;RC(+)组年龄小于RC(-)组,SD大于RC(-)组,差异有统计学意义(P<0.05和P<0.01);SD对预测EV组病人中RC的曲线下面积为0.705,临界值151,灵敏度66.1%,特异度64.5%。结论:PC、SD、PC/SD、FIB-4对EV的预测均有一定的临床价值,PC/SD、SD联合能较好地预测EV;SD是肝硬化EV病人RC的独立危险因素。

Objective:To investigate the clinical value of spleen longitudinal diameter(SD),platelet count(PC),PC/SD and FIB-4 index in predicting the cirrhotic esophageal varices(EV).Methods:The clinical data of 134 patients with cirrhosis were collected.The esophageal varices in all patients were examined using gastroscopy.According to the presence or absence of EV,the patients were divided into the EV group and non-EV group,and the EV group was subdivided into the RC(+)group and RC(-)group according to the red color sign(RC)The diagnostic efficacy of PC,SD,PC/SD and FIB-4 in EV were evaluated,and the influencing factors of RC was analyzed.Results:The PC,WBC and PC/SD in EV group were lower than those in non-EV group,and the SD,FIB-4,Child-Pugh score and PT in EV group were higher than those in non-EV group(P<0.05 to P<0.01).The areas under the curve predicted by PC,SD,PC/SD and FIB-4 for EV were 0.781,0.811,0.811 and 0.715,respectively.The area under the curve predicted by SD and PC/SD for EV was 0.822,the sensitivity was 85.4%,and the specificity was 71.1%.The age in RC(+)group was less than that in RC(-)group,and the SD in RC(+)group was greater than that in RC(-)group(P<0.05 and P<0.01).The area under the curve of SD for predicting RC in EV group was 0.705,the cutoff value was 151,the sensitivity was 66.1%and the specificity was 64.5%.Conclusions:The PC,SD,PC/SD and FIB-4 have certain clinical value in predicting EV.The combination of PC/SD and SD can better predict.The SD is an independent risk factor for RC in patients with cirrhotic EV.