BRTO治疗后肝静脉压力梯度水平与肝硬化患者食管静脉曲张破裂出血的相关性研究  

Correlation study between hepatic venous pressure gradient after balloon-occluded retrograde transvenous obliteration and esophageal variceal rupture and bleeding in patients with liver cirrhosis

作　　者：刘正金[1] 郭锦教 符仲标 王勇[2] LIU Zheng-jin;GUO Jin-jiao;FU Zhong-biao;WANG Yong(Department of Gastroenterology,Second Affiliated Hospital of Hainan Medical College,Haikou Hainan,570311,China;不详)

机构地区：[1]海南医学院第二附属医院消化内科,海南海口570311 [2]海南医学院第二附属医院介入血管外科,海南海口570311

出　　处：《中西医结合肝病杂志》2024年第8期695-699,共5页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：海南省卫生健康行业科研项目(No.21A200126)。

摘　　要：目的:探讨胃底静脉曲张(GV)患者行BRTO治疗前后肝静脉压力梯度(HVPG)水平在早期评估肝硬化患者食管静脉曲张破裂出血(EVB)发生风险的价值。方法:纳入2021年10月至2022年6月在我院接受BRTO术治疗的失代偿期肝硬化合并GV患者94例。收集患者临床资料;测量BRTO治疗前后HVPG水平。随访1年,根据患者是否发生EVB分为EVB组和对照组。采用Logistic回归分析BTRO术后EVB的相关因素;绘制ROC曲线分析BRTO术后HVPG水平在早期预测EVB的应用价值。结果:经过1年随访,94例患者共发生21例EVB,发生率为22.34%。临床资料显示EVB组患者Alb水平低于对照组,BRTO术后HVPG水平、男性比例高于对照组,差异具有统计学意义(P<0.05);Logistic回归分析显示,Alb水平(OR=0.807)是肝硬化患者BRTO术后近期发生EVB的独立保护因素(P<0.05),BRTO术后HVPG水平(OR=1.378)是肝硬化患者BRTO术后近期发生EVB的独立危险因素(P<0.05)。ROC曲线分析显示,BRTO术后HVPG水平在早期预测肝硬化患者发生EVB的敏感性为76.19%,特异性为82.19%,截点值为15.54 mmHg。结论:BRTO治疗GV后通过测定术后HVPG水平能够早期预警肝硬化患者EVB发生风险。Objective:Exploring the Value of Hepatic Venous Pressure Gradient(HVPG)Levels Before and After Balloon-Occluded Retrograde Transvenous Obliteration(BRTO)Treatment in Early Assessment of the Risk of Esophageal Variceal Bleeding(EVB)in Patients with Gastric Varices(GV).Methods:A total of 94 patients with decompensated liver cirrhosis complicated by Gastric Varices(GV)who underwent Balloon-Occluded Retrograde Transvenous Obliteration(BRTO)surgery at our hospital from October 2021 to June 2022 were included.Clinical data of the patients were collected,and the levels of Hepatic Venous Pressure Gradient(HVPG)before and after BRTO treatment were measured.Patients were followed up for one year and divided into the Esophageal Variceal Bleeding(EVB)group and the control group based on whether EVB occurred.Logistic regression analysis was used to analyze the correlation between BRTO postoperative HVPG levels and EVB,and the Receiver Operating Characteristic(ROC)curve was plotted to analyze the application value of HVPG levels after BRTO in the early prediction of EVB.Results:After 1-year follow-up,21 cases of EVB occurred in 94 patients,with an incidence rate of 22.34%.Comparison of clinical data after grouping accordingly showed that the albumin level of the EVB group was lower than that of the control group,and the HVPG level and the proportion of males after BRTO treatment were higher than that of the control group,with statistically significant differences(P<0.05).Logistic regression analysis showed that the albumin level(or=0.807)was an independent protective factor for the occurrence of EVB in cirrhotic patients in the near future after BRTO treatment(P<0.05),and HVPG level after BRTO treatment(or=1.378)was an independent risk factor for the recent occurrence of EVB after BRTO treatment in patients with liver cirrhosis(P<0.05).The ROC curve analysis showed that the sensitivity of HVPG level after BRTO treatment in early prediction of the occurrence of EVB in patients with liver cirrhosis was 76.19%,and specificity was

关 键 词：球囊阻断逆行经静脉闭塞术 肝静脉压力梯度 食管静脉曲张破裂出血 肝硬化 

分 类 号：R575.2[医药卫生—消化系统]