血瘀证积分与HBV相关肝硬化食管胃底静脉曲张的相关性研究

The correlation between the blood stasis scores and gastroesophageal varices in HBV-related liver cirrhosis

目的:探讨血瘀证积分与乙型肝炎病毒(HBV)相关肝硬化患者食管胃底静脉曲张的相关性,评估通过血瘀证积分排除高风险静脉曲张的诊断效能。方法:收集2021年12月至2023年2月于新疆医科大学附属中医医院就诊的HBV相关肝硬化患者110例,根据胃镜结果分为高风险静脉曲张组和非高风险静脉曲张组,对他们进行血瘀证积分评分,采用相关性分析评价血瘀证积分与食管胃底静脉曲张的相关性,通过受试者工作特征曲线评价血瘀证积分、肝脏硬度值测定(LSM)、LSPS评分、FIB-4指数、APRI指数排除高风险静脉曲张的效能。结果:血瘀证积分与HBV相关肝硬化患者静脉曲张程度存在正相关,相关系数为0.773;血瘀证积分排除高风险静脉曲张的AUC为0.955,截断值为5分,灵敏度和特异度分别为93.5%和87.8%,阳性预测值:82.7%,阴性预测值:95.6%;LSM、LSPS评分、FIB-4指数、APRI指数排除HRV的AUC在0.735~0.864之间,灵敏度在73.9%~95.7%之间,特异度在62.2%~86.5%之间,阳性预测值在56.9%~77.3%之间,阴性预测值在83.6%~96.4%之间。结论:血瘀证积分与HBV肝硬化患者食管胃底静脉曲张存在正相关,血瘀证积分在排除高风险静脉曲张方面具有一定效能,并且优于其他无创指标。

Objective:To investigate the correlation between The blood stasis points and gastroesophageal varices in patients with HBV-related liver cirrhosis,and to evaluate the efficacy of The Blood Stasis Points in excluding high-risk varicose veins.Methods:A total of 110 patients with hepatitis B-related cirrhosis who were admitted to The Fourth Affiliated Hospital of Xinjiang Medical University from December 2021 to February 2023 were collected.Then they were divided into high-risk varicose veins group and non-high-risk varicose veins based on gastroscopy.They were evaluated with blood stasis scores,and the correlation analysis was used to evaluate the correlation between blood stasis points and gastroesophageal varices.Also,the subjects'work characteristic curve was evaluated as blood stasis scores,LSM,LSPS scores,FIB-4 index.The APRI index is effective in excluding high-risk varicose veins.Results:There was a positive correlation between blood stasis score and the degree of varicose veins in patients with HBV-related liver cirrhosis with a correlation coefficient of 0.773.The AUC of blood stasis score excluding high-risk varicose veins was 0.955,the cut-off value was five points,the sensitivity and specificity were 93.5%and 87.8%,the positive predictive value was 82.7%,and the negative predictive value was 95.6%.The AUC of LSM,LSPS score,FIB-4 index,and APRI index excluding HRV ranged from 0.735 to 0.864,sensitivity ranged from 73.9%to 95.7%,specificity ranged from 62.2%to 86.5%,positive predictive value ranged from 56.9%to 77.3%,and negative predictive value ranged from 83.6%to 96.4%.Conclusion:There is a positive correlation between the blood stasis scores and gastroesophageal varices in patients with HBV cirrhosis.Also,the blood stasis scores have certain efficacy in excluding high-risk varicose veins,and they are better than other noninvasive indicators.