脾厚徑聯(lián)合常規(guī)臨床指標有效預測肝硬化食管靜脈曲張
發(fā)布時間：2018-11-15 07:54
【摘要】：目的篩選獲得診斷肝硬化食管靜脈曲張(EV)無創(chuàng)性診斷指數(shù)。方法回顧性分析經(jīng)我院臨床確診的202例乙型、丙型肝炎以及酒精性肝病引起的肝硬化患者臨床資料,以胃鏡確診EV和高風險EV(HREV),彩色多普勒超聲診斷儀測量肝、膽囊、脾及其血管參數(shù),結合臨床血液常規(guī)和生化指標,進行統(tǒng)計學分析,評價單指標、多指標序貫或同步聯(lián)合模型對EV、HREV的無創(chuàng)性診斷效能。結果脾厚徑(SPT)診斷EV、HREV的受試者工作特征曲線下面積分別為0.827、0.766,聯(lián)合指數(shù)1(超聲評分、SPT、白細胞計數(shù)及白蛋白)的診斷EV工作特征曲線下面積為0.873,聯(lián)合指數(shù)2(SPT、白蛋白)的診斷HREV工作特征曲線下面積為0.777。SPT與聯(lián)合指數(shù)1或血小板/脾厚徑比值的同步聯(lián)合可完全排除EV可能,SPT與聯(lián)合指數(shù)1或血小板的序貫聯(lián)合可完全確定EV診斷,約半數(shù)患者可完全明確EV狀態(tài)。SPT與聯(lián)合指數(shù)2聯(lián)合診斷可明確10%患者HREV狀態(tài)。結論 SPT聯(lián)合基于SPT的指數(shù)或血小板可使部分患者完全確定有或無EV,是有效的肝硬化EV無創(chuàng)診斷手段。
[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.
【作者單位】： 南方醫(yī)科大學南方醫(yī)院感染內科;南方醫(yī)科大學南方醫(yī)院超聲科;南方醫(yī)科大學南方醫(yī)院消化內科;
【基金】：南方醫(yī)科大學南方醫(yī)院院長基金(2014B021)
【分類號】：R575.2
本文編號：2332654
[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.
【作者單位】： 南方醫(yī)科大學南方醫(yī)院感染內科;南方醫(yī)科大學南方醫(yī)院超聲科;南方醫(yī)科大學南方醫(yī)院消化內科;
【基金】：南方醫(yī)科大學南方醫(yī)院院長基金(2014B021)
【分類號】：R575.2
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1 徐菁;張志勇;;自體外周血干細胞移植治療乙型肝炎肝硬化臨床觀察[J];檢驗醫(yī)學與臨床;2014年10期
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