[1]李焱,孙长宇#,周言.非侵入性指标诊断肝硬化食管静脉曲张的价值*[J].郑州大学学报(医学版),2013,(04):505.
 LI Yan,SUN Changyu,ZHOU Yan.Value of noninvasive parameters in dignosis of esophageal varices for patients with liver cirrhosis[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2013,(04):505.
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非侵入性指标诊断肝硬化食管静脉曲张的价值*
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2013年04期
页码:
505
栏目:
应用研究
出版日期:
2013-07-20

文章信息/Info

Title:
Value of noninvasive parameters in dignosis of esophageal varices for patients with liver cirrhosis
作者:
李焱 孙长宇#周言
郑州大学第一附属医院感染科 郑州 450052
Author(s):
LI Yan SUN Changyu ZHOU Yan
Department of Infectious Diseases, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052
关键词:
食管静脉曲张肝硬化非侵入性评估
Keywords:
esophageal varices liver cirrhosis noninvasive prediction
分类号:
R571+.3
摘要:
目的:探讨肝硬化患者化验、检查指标对食管静脉曲张的评估及早期筛查诊断的价值。方法:依据胃镜检查结果将102例肝硬化患者分为无食管静脉曲张组(n=30)和食管静脉曲张组(n=72),收集年龄、性别、血小板总数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)、血小板分布宽度(PDW)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、AST/ALT、血清白蛋白(Albumin)、血清总胆红素(TBil)、凝血时间(PT)、凝血酶原活动度(PTA)、AST与PLT之比(APRI)、门静脉内径(PVD)、脾静脉内径(SVD)、脾脏厚径(ST)、PLT/ST,分析上述指标与食管静脉曲张的关系,建立回归方程模型,绘制ROC曲线,确定筛查诊断界值。结果:logit(食管静脉曲张率)=-14.739+1.036×PDW-0.684×PLT/ST-0.008×ALT,PDW(OR=2.871,95%CI为1.273~6.233)、PLT/ST(OR=0.505, 95%CI为0.349~0.730)、ALT(OR=0.992, 95%CI为0.984~1.000)。回归方程的ROC曲线下面积为0.883(95%CI为0.810~0.957)。以3.41为食管静脉曲张非侵入性筛查诊断界限值时,敏感度90.3%,特异度76.7%,约登指数0.67。结论:检测肝硬化患者PLT、PDW、ALT、ST可评估食管静脉曲张。
Abstract:
Aim: To assess the value of noninvasive parameters in dignosis of esophageal varices for patients with liver cirrhosis. Methods:A total of 102 patients with liver cirrhosis were classified as negative(n=30) and positive(n=72) groups by gastroscopy. The data were inferred by univariate analysis and multivariate regression analysis. The function was evaluated by the receiver operating characteristic (ROC) curves and the optimal criterion values were calculated to predict EV. Results: Logistic regression analysis showed that logit(P)=-14.739+1.036×PDW-0.684×PLT/ST-0.008×ALT, PDW(OR=2.871,95%CI 1.273-6.233), PLT/ST(OR=0.505,95%CI 0.349-0.730), ALT(OR=0.992,95% CI 0.984-1.000). With the dependent variable cut off value of 3.41, the regression function had a sensitivity of 90.3%, a specificity of 76.7%, and the value of Youden index was 0.67. Conclusion: PDW, PLT/ST and ALT may be used to predict the presence of EV in patients with liver cirrhosis.

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备注/Memo

备注/Memo:
*卫生部国际交流与合作中心合作基金资助项目IHECC2011005 #通讯作者,男,1969年10月生,博士,主任医师,教授,研究方向:病毒性肝炎、肝硬化的诊治,Email:scy691014@yahoo.com.cn
更新日期/Last Update: 2013-07-25