胃肠双重造影联合血清学检测在诊断肝硬化合并食管胃底静脉曲张中的应用价值

Application value of gastroenterography combined with serological detection in the diagnosis of esophageal and gastric varices

目的 探讨胃肠双重造影联合血清学检测在诊断中、重度食管胃底静脉曲张中的应用价值。方法 选取2020年5月至2021年12月在杭州市西溪医院及浙江医院收治的106例肝硬化合并食管胃底静脉曲张患者,均行胃镜及胃肠超声造影检查,以胃镜结果为标准,将食管胃底静脉曲张患者分为轻、中、重度组。分别记录和测量三组患者的胃底食管静脉的形态、管腔最大内径、最大血流速度、血小板计数及白蛋白数值,以便分析此次联合检测在诊断胃底食管静脉曲张严重程度中的临床应用价值。结果 食管胃底静脉最大内径、最大血流速度与静脉曲张严重程度呈正相关(r分别为0.860、0.845,P<0.05),血小板计数和白蛋白数值与静脉曲张严重程度呈负相关(r分别为–0.755、–0.826,P<0.05)。食管胃底静脉最大内径、最大血流速度、血小板计数及白蛋白数值联合诊断的曲线下面积为0.996,敏感度为100%,特异性为94.7%。结论 胃肠双重造影联合血清学指标检测可准确预测肝硬化患者的中、重度食管胃底静脉曲张。

Objective To explore the application value of gastrointestinal double contrast imaging combined with serological detection in the diagnosis of moderate to severe esophageal and gastric varices.Methods A total of 106 patients with liver cirrhosis combined with esophageal-gastric varices admitted to Xixi Hospital and Zhejiang Hospital in Hangzhou from May 2020 to December 2021 were selected for gastroscopy and gastrointestinal ultrasound contrast examination.Based on the results of gastroscopy,patients with esophageal-gastric varices were divided into mild,moderate,and severe groups.The morphology,maximum inner diameter,maximum blood flow velocity,platelet and albumin values of the gastroesophageal veins in three groups of patients were recorded and measured,in order to analyze the clinical application value of this combined detection in diagnosing the severity of esophageal-gastric varices.Results The maximum diameter and blood flow velocity of the esophageal-gastric varices were positively correlated with the severity of varices(r were 0.860,0.845,P<0.05),while platelets and albumin were negatively correlated with the severity of varices(r were –0.755,–0.826,P<0.05).The area under the curve for the combined diagnosis of the maximum inner diameter,maximum blood flow velocity,platelets,and albumin of the esophageal-gastric varices was 0.996,with a sensitivity of 100% and a specificity of 94.7%.Conclusion Gastrointestinal double contrast imaging combined with serological indicators can accurately predict moderate to severe esophageal-gastric varices in patients with liver cirrhosis.