无创指标诊断肝硬化食管静脉曲张的临床研究

Clinical Study of Non-invasive Diagnosis of Esophageal Karices In Liver Cirrhosis

目的探讨无创指标诊断肝硬化食管静脉曲张(Esophageal Varices,EV)的诊断效能,并构建预测肝硬化患者有无EV的无创模型。方法选择本院就诊的138例肝硬化患者(2018年1月至2021年9月),收集患者血常规、凝血功能、肝功能、腹部超声、胃镜检查等临床资料。按照胃镜检查结果有无EV分为有食管静脉曲张组(EV+组)71例,无食管静脉曲张组(EV-组)67例,比较两组指标之间的差异性。结果结果显示,EV+组患者的WBC、RBC、HGB、PLT、PT%、FIB、CHE显著低于EV-组患者;EV+组患者的PT、INR、TT显著高于EV-组患者,EV+组患者的肝静脉及脾静脉内径宽于EV-组患者,且门脉血流速度较慢;EV+组患者比EV-组患者的脾脏更长、更厚,以上差异均有统计学意义(P<0.05)。结论肝硬化患者的年龄、性别、民族、吸烟和饮酒情况与EV的发生无关;WBC、FIB、PVD是食管静脉曲张发生与否的独立预测因素;模型、APRI、FIB-4、PC/SD均可以有效预测肝硬化EV的发生,模型的诊断效能更佳。

Objective Discuss the diagnostic efficacy of noninvasive index diagnosis of cirrhosis and construct a non-invasive model to predict Esophageal Varices(EV)in cirrhosis patients.Methods Selected 138 patients with cirrhosis presenting to our hospital from january 2018 to september 2021,Collect clinical data on blood routine,coagulation function,liver function,abdominal ultrasound,and gastroscopy.According to the gastroscopy results,71 patients were classified in the EV+group and 67 patients in the EV-group,Compare the variability between the two data groups.Results The results showed that WBC,RBC,HGB,PLT,PT%,FIB and CHE were significantly lower in EV-patients than EV+group;EV+patients had significantly higher PT,INR and TT than EV-patients,the vena hepatica andspleen vein diameterin the EV+group were wider than those in the EV-group,and the portal blood flow rate in the EV+group was slower;Patients in the EV+group had a longer and thicker spleen than those in the EV-group,all of the above differences were statistically significant(P<0.05).Conclusion Age,sex,ethnicity,smoking and drinking situation of patients with cirrhosis are not related to the presence of esophageal veins;WBC,FIB and PVD are independent predictors of esophageal veins in cirrhosis patients;Model,APRI,FIB-4 and PC/SD can effectively predict the occurrence of EV and have better diagnostic efficacy of the model.