乙型肝炎后肝硬化患者食管静脉曲张发生的无创性预测指标研究

发布时间：2018-02-26 06:31

本文关键词： 肝硬化食管静脉曲张预测模型无创性　出处：《上海交通大学学报(医学版)》2015年03期 　论文类型：期刊论文

【摘要】：目的探讨肝硬化患者发生食管静脉曲张(EV)的无创性指标。方法收集肝硬化住院患者274例,记录性别、年龄、发病原因、外周血小板计数(PLT)、总胆红素、白蛋白、凝血时间、国际标准化比值(INR)、粪便潜血(OB)、脾脏长径(SD)和厚度以及门静脉宽度。首先对150例肝硬化患者各指标分别进行方差分析和多因素Logistic回归分析,建立预测模型,分别用预测模型与单独PLT、PLT/SD值验证另外124例肝硬化患者有无EV发生,比较这些指标的受试者工作特征曲线下面积(AUCROC)、特异度及敏感度。结果多因素Logistic回归分析显示:PLT、SD、INR及OB结果共同构建的模型可作为肝硬化患者EV的预测指标(P0.05);AUCROC的计算结果显示:预测模型AUCROC(95%CI)为0.925(0.881,0.969),模型与PLT/SD(χ2=7.212,P=0.007)和PLT(χ2=9.412,P=0.002)有关,PLT/SD与PLT有关(χ2=0.186,P=0.666),提示预测模型对有无EV发生的预测更具优势。结论 PLT、SD、INR、OB实验结果建立的预测模型对肝硬化患者发生EV的风险有较好的预测作用。
[Abstract]:Objective to investigate the noninvasive indexes of esophageal varices in patients with cirrhosis. Methods 274 inpatients with cirrhosis were collected to record their sex, age, etiology, peripheral platelet count (PLT), total bilirubin, albumin and coagulation time. International standardized ratio (INRN), fecal occult blood (OB), spleen long diameter (SDD), and portal vein width (portal vein width) were analyzed by ANOVA and multivariate Logistic regression analysis in 150 patients with liver cirrhosis, and a predictive model was established. A predictive model and a single PLT / SD value were used to verify the presence of EV in another 124 patients with liver cirrhosis. The area under the operating characteristic curve, specificity and sensitivity of the subjects were compared. Results the multivariate Logistic regression analysis showed that the model constructed with the results of Logistic and OB could be used as a predictor of EV in cirrhotic patients (P 0.05). The results showed that the prediction model AUCROC95 CII was 0.925 0.8810.9690.The prediction model was related to PLT / SD (蠂 ~ 2 / 212P ~ (0.007)) and PLT (蠂 ~ (29.412) P ~ (0.002) P ~ (0.002)) related to PLT (蠂 ~ (20.186) P ~ (0.666N)). Conclusion the prediction model has more advantages in predicting the occurrence of EV in patients with liver cirrhosis. The risk has a good predictive effect.
【作者单位】：广东省南方医科大学附属珠江医院消化内科;
【基金】：广东省科技厅科技计划项目(2009B030801212)~~
【分类号】：R575.2;R512.62

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