血小板计数预测肝硬化患者食管静脉曲张发生风险的探讨  

Efficiency of platelet count in predicting occurrence risk of esophageal varices in patients with liver cirrhosis

作　　者：杨炜炜[1] 杨建华[1] YANG Weiwei;YANG Jianhua(Department of Infectious Diseases,Baoji Central Hospital,Baoji,Shaanxi,721008)

机构地区：[1]陕西省宝鸡市中心医院感染性疾病科,陕西宝鸡721008

出　　处：《实用临床医药杂志》2018年第19期101-105,共5页Journal of Clinical Medicine in Practice

摘　　要：目的探讨血小板计数预测肝硬化患者食管静脉曲张(EVs)发生风险的效果。方法选取110例肝硬化患者,记录患者的病史、体格检查、实验室指标、超声扫描和肝脏活检情况。通过内镜检查确定患者的EVs情况。计算所有患者的肝纤维化四指数(FIB-4)评分。采用Spearman相关性分析EVs与血小板计数及FIB-4评分的相关性。结果所有患者中共87例(79. 09%)出现食管静脉曲张。在发生血小板减少症(血小板<150 000/μL)的患者中,20例(25. 97%)为Ⅱ级EVs,21例(27. 27%)为Ⅲ～Ⅳ级EVs。血小板计数在150 000/μL以上的患者中,只有7例(21. 21%)为Ⅱ级EVs,3例(9. 09%)为Ⅲ～Ⅳ级EVs。相关性分析显示,中高级EVs的发生与患者血小板计数和FIB-4显著相关(P <0. 05)。结论血小板计数是一种无创性的、高准确度的预测EVs的参数。血小板计数正常(150 000/μL以上)肝硬化患者静脉曲张破裂出血风险较低。Objective To explore efficiency of platelet count in predicting occurrence risk of esophageal varices （EVs） in patients with liver cirrhosis. Methods A total of 110 liver cirrhosis patients were selected. The patient＇s history, physical examination, laboratory parameters, ultrasonography and liver biopsy were recorded. EVs was determined by endoscopy. The FIB-4 score was calculated in all the patients. Correlations between EVs and platelet count, FIB-4 score were analyzed by Spearman correlation analysis. Results Esophageal varices were found in 87 patients （79.09%）. In patients with thrombocytopenia （thrombocytopenia less than 150 000/μL）, 20 patients （ 25.97% ） had grade Ⅱ EVs and 21 cases （27.27%） had grade Ⅲ～Ⅳ EVs. In patients with platelet counts above 150 000/μL, only 7 patients （21.21%） had grade Ⅱ EVs and 3 patients （ 9.09% ） had grade Ⅲ～Ⅳ EVs. Correlation analysis showed that the occurrence of intermediate and advanced EVs was significantly correlated with platelet count and FIB-4 （ P 〈0.05）. Conclusion Platelet count is a non-invasive and highly accurate parameter for predicting EVs. Liver cirrhosis patients with normal platelet count （above 150 000/μL） had a lower risk of bleeding caused by EVs.

关 键 词：肝硬化 食管静脉曲张 肝纤维化四指数 血小板计数 

分 类 号：R657.3[医药卫生—外科学]