血小板数与脾大小之比、血清-腹水白蛋白梯度与肝硬化食管静脉曲张的关系

目的探讨I缸小板数与脾大小之比、血清-腹水白蛋白梯度和肝硬化食管静脉曲张的关系。方法对101例肝硬化合并腹水者进行生化检测、腹部B超、胃镜检查，分析食管静脉曲张与脾长、脾厚、脾大小（长×厚）、门静脉及脾静脉直径、血小板数、血小板数与脾大小之比及血清-腹水自蛋白梯度的关系。结果食管静脉曲张组血小板数与脾大小之比为1.4±1.0.其血清-腹水白蛋白梯度为（24.1±10.4）g／L。无食管静脉曲张组血小板数与脾大小之比为1.9±0.9，其血清-腹水白蛋白梯度为（14.4±8.3）g／L，两者比较有显著性差异，经Logistic回归分析其可预测食管静脉曲张的发生。结论当内镜不能顺利实施时，血小板数与脾大小之比及血清-腹水向蛋白梯度可作为预测食管静脉曲张的一种经济、无创的手段。

The relationship between platelet count to spleen sizes ratio, serum-ascites album gradient and esophageal varices in liver cirrhosis

Objective To study the value of platelet count to spleen sizes ratio and serum-ascites album gradient (SSAG) as a noninvasive parameter for diagnosing esophageal varices (EV) in liver cirrhosis. Methods The laboratory and ultrasonographic variables were prospectively evaluated in 101 patients with liver cirrhosis. All patients underwent up-per gastrointestinal endoscopy. Results The platelet count to spleen sizes ratio and SSAG in patients with EV were 1.4± 1.0 and 24.1±10.4 g/L. The platelet count to spleen sizes ratio and SSAG in patients without EV were 1.9±0.9 and 14.4± 8.3 g/L. There was significant difference between patients with and without EV. The platelet count to spleen sizes ratio and SSAG had the highest accuracy among all parameters and they could predict the presence of esophageal varices in liver cirrhosis . Conclusions The platelet count to spleen sizes ratio and SSAG may be a useful tool for diagnosing EV in liver cirrhosis noninvasively when endoscopy facilities are not available.