胃肠超声造影联合血清指标在预测胃底食道静脉重度曲张中的应用价值  

作　　者：孙希希 吴圣波 黄斌 姚蓝 蒋孝鸣 柴佳园 孔梓祥 

机构地区：[1]浙江医院,310013 [2]杭州市西溪医院,310023

出　　处：《浙江临床医学》2023年第8期1208-1210,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省公益基础研究计划项目(LGF20H180011)。

摘　　要：目的探讨胃肠超声造影联合血清指标构建联合模型用于识别胃底食道静脉重度曲张的应用价值。方法回顾性分析2020年5月至2021年12月在浙江医院及杭州西溪医院行胃肠超声造影的102例确诊为肝硬化患者的相关资料,记录每位患者血小板、白蛋白、部分凝血酶原具体数值,胃底静脉曲张内径及流速,以胃镜为标准,将患者分为胃底食道静脉重度曲张组和非重度曲张组,采用二元Logistic回归法,评估上述方法对胃底食道静脉重度曲张的诊断价值,并建立受试者工作特征(ROC)曲线,评估联合诊断对胃底食道静脉重度曲张诊断的敏感性及特异性。结果共纳入重度曲张组患者共计38例,非重度曲张组患者64例,用二元Logistic回归分析显示血小板、白蛋白、部分凝血酶(APTT)及胃肠超声造影对胃底食道静脉重度曲张诊断差异均有统计学意义(P<0.05),胃肠超声联合血清指标在胃底食道静脉重度曲张识别中的AUC值0.997,在诊断重度胃底食道曲张中显示出良好的诊断效能。结论双重胃肠造影联合血小板、白蛋白、部分凝血酶原时间构建联合模型可作为一种量化工具识别胃底食道静脉重度曲张,提供临床早期甄别高出血风险人群。Objective To explore the application value of joint model based on gastrointestinal contrast-enhanced ultrasound and serum indexes in the identification of severe esophageal and gastric varices.Methods The relevant data of 102 patients with cirrhosis who received gastrointestinal contrastenhanced ultrasound in Zhejiang Hospital and Hangzhou Xixi Hospital from May 2020 to December 2021 were retrospectively analyzed.The values of platelets,albumin,activated partial thromboplastin time(APTT),inner diameter and flow rate of severe esophageal and gastric varices were recorded.According to the standard of gastroscopy,the patients were divided into the severe varices group and the non-severe varices group.Binary Logistic regression was used to evaluate the diagnostic value of the above methods for severe esophageal and gastric varices,and the receiver operating characteristic(ROC)curve was established to evaluate the sensitivity and specificity of the combined diagnosis for severe esophageal and gastric varices.Results A total of 38 patients were included in the severe varices group and 64 patients in the non-severe varices group.Binary Logistic regression analysis showed that platelet,albumin,APTT and gastrointestinal contrast ultrasonography had statistical significance in the diagnosis of severe esophageal and gastric varices(P<0.05).The AUC value of gastrointestinal ultrasonography combined with serum indexes in the identification of severe esophageal and gastric varices was 0.997,it shows good diagnostic efficacy in the diagnosis of severe esophageal and gastric varices.Conclusion The joint model gastrointestinal contrast-enhanced ultrasound combined with platelets,albumin and APTT can be used as a quantitative tool to identify severe esophageal and gastric varices,provide evidence for early clinical identification of patients with high risk of bleeding.

关 键 词：胃底食道静脉重度曲张 曲张静脉内径 曲张静脉流速 血小板 白蛋白 部分凝血酶原时间 

分 类 号：R573[医药卫生—消化系统]