脾厚径联合常规临床指标有效预测肝硬化食管静脉曲张
发布时间：2018-11-15 07:54
【摘要】：目的筛选获得诊断肝硬化食管静脉曲张(EV)无创性诊断指数。方法回顾性分析经我院临床确诊的202例乙型、丙型肝炎以及酒精性肝病引起的肝硬化患者临床资料,以胃镜确诊EV和高风险EV(HREV),彩色多普勒超声诊断仪测量肝、胆囊、脾及其血管参数,结合临床血液常规和生化指标,进行统计学分析,评价单指标、多指标序贯或同步联合模型对EV、HREV的无创性诊断效能。结果脾厚径(SPT)诊断EV、HREV的受试者工作特征曲线下面积分别为0.827、0.766,联合指数1(超声评分、SPT、白细胞计数及白蛋白)的诊断EV工作特征曲线下面积为0.873,联合指数2(SPT、白蛋白)的诊断HREV工作特征曲线下面积为0.777。SPT与联合指数1或血小板/脾厚径比值的同步联合可完全排除EV可能,SPT与联合指数1或血小板的序贯联合可完全确定EV诊断,约半数患者可完全明确EV状态。SPT与联合指数2联合诊断可明确10%患者HREV状态。结论 SPT联合基于SPT的指数或血小板可使部分患者完全确定有或无EV,是有效的肝硬化EV无创诊断手段。
[Abstract]:Objective to obtain the non-invasive diagnostic index of (EV) for the diagnosis of esophageal varices in cirrhotic patients. Methods the clinical data of 202 patients with cirrhosis caused by hepatitis B, hepatitis C and alcoholic liver disease were analyzed retrospectively. The liver and gallbladder were measured by gastroscopy EV and high risk EV (HREV), color Doppler ultrasound. The parameters of spleen and blood vessels, combined with clinical routine and biochemical indexes, were analyzed statistically to evaluate the noninvasive diagnostic effectiveness of single index, multiple index sequential or synchronous combined model for EV,HREV. Results the area under the operating characteristic curve of (SPT) for diagnosing EV,HREV was 0.8270.766.The area under the diagnostic characteristic curve of EV was 0.873in combination index 1 (ultrasound score, SPT, white blood cell count and albumin). In the diagnosis of HREV with combined index 2 (SPT, albumin), the area under the work characteristic curve of 0.777.SPT and the combination index 1 or the ratio of platelet to spleen thickness can completely exclude the possibility of EV. Sequential combination of SPT with combined index 1 or platelet can completely determine the diagnosis of EV, and about half of the patients can determine the state of EV completely, and 10% of the patients with HREV can be diagnosed by SPT combined with combined index 2. Conclusion SPT combined with index or platelet based on SPT can completely determine whether there is EV, or not in some patients.
【作者单位】： 南方医科大学南方医院感染内科;南方医科大学南方医院超声科;南方医科大学南方医院消化内科;
【基金】：南方医科大学南方医院院长基金(2014B021)
【分类号】：R575.2
本文编号：2332655
[Abstract]:Objective to obtain the non-invasive diagnostic index of (EV) for the diagnosis of esophageal varices in cirrhotic patients. Methods the clinical data of 202 patients with cirrhosis caused by hepatitis B, hepatitis C and alcoholic liver disease were analyzed retrospectively. The liver and gallbladder were measured by gastroscopy EV and high risk EV (HREV), color Doppler ultrasound. The parameters of spleen and blood vessels, combined with clinical routine and biochemical indexes, were analyzed statistically to evaluate the noninvasive diagnostic effectiveness of single index, multiple index sequential or synchronous combined model for EV,HREV. Results the area under the operating characteristic curve of (SPT) for diagnosing EV,HREV was 0.8270.766.The area under the diagnostic characteristic curve of EV was 0.873in combination index 1 (ultrasound score, SPT, white blood cell count and albumin). In the diagnosis of HREV with combined index 2 (SPT, albumin), the area under the work characteristic curve of 0.777.SPT and the combination index 1 or the ratio of platelet to spleen thickness can completely exclude the possibility of EV. Sequential combination of SPT with combined index 1 or platelet can completely determine the diagnosis of EV, and about half of the patients can determine the state of EV completely, and 10% of the patients with HREV can be diagnosed by SPT combined with combined index 2. Conclusion SPT combined with index or platelet based on SPT can completely determine whether there is EV, or not in some patients.
【作者单位】： 南方医科大学南方医院感染内科;南方医科大学南方医院超声科;南方医科大学南方医院消化内科;
【基金】：南方医科大学南方医院院长基金(2014B021)
【分类号】：R575.2
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