无创检测指标评估肝硬化食道静脉曲张的研究

目的评估无创检测指标与食道静脉曲张的相关性，通过无创检测指标判断肝硬化患者是否须要进行胃镜检查。方法251例肝硬化患者分为食道静脉曲张组和无食道静脉曲张组。采用多因素Logistic回归分析法评估Child—Pugh评分、凝血酶原活动度（prothrombin activity，PTA）、血小板（platelet，PLT）计数、脾厚、门静脉直径（portal vein diameter，PVD）等无创检测指标与食道静脉曲张的相关性。应用受试者工作特性曲线分析我们建立的基于PTA与PLT的3分评分系统对食道静脉曲张的灵敏度和特异度的评估。结果PTA、PLT、出现肝性脑病、出现腹水在2组间的差异有统计学意义，而总胆红素、PVD、脾厚、清蛋白及Child—Pugh评分在2组间的差异无统计学意义。多因素Logistic回归分析提示PTA〈70％、PLT〈100×10^9／L与存在食道静脉曲张明显相关。我们建立的3分评分系统的曲线下面积为0．73，0分预测出现食道静脉曲张的灵敏度为100％，特异度为0；1分预测出现食道静脉曲张的灵敏度为89．10％，特异度为32．50％；2分预测出现食道静脉曲张的灵敏度为70．60％，特异度65．00％；3分预测出现食道静脉曲张的灵敏度为64．70％，特异度为77．50％。结论对于PTA≥70％，尤其合并PLT≥100×10^9／L的肝硬化患者可以根据患者的具体情况酌情暂缓胃镜检查。

Evaluation of non-invasive diagnostic markers on the presence of esophageal varices in cirrhotic patients

Objective To evaluate the correlation between non-invasive diagnostic markers and the presence of esophageal varices, and determine the necessity of gastroscopic screening for liver cirrhosis according to non-invasive diagnostic markers. Methods A total of 251 cirrhotic patients were divided into non-esophageal varices group and esophageal varices group. Logistic regression was used to evaluate the correlation between the presence of esophageal varices and non-invasive diagnostic markers, such as Child-Pugh...