Predictive models and clinical manifestations of intrapulmonary vascular dilatation and hepatopulmonary syndrome in patients with cirrhosis:Prospective comparative study  

作　　者：Zhi-Peng Wu Ying-Fei Wang Feng-Wei Shi Wen-Hui Cao Jie Sun Liu Yang Fang-Ping Ding Cai-Xia Hu Wei-Wei Kang Jing Han Rong-Hui Yang Qing-Kun Song Jia-Wei Jin Hong-Bo Shi Ying-Min Ma 

机构地区：[1]Beijing Institute of Hepatology,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China [2]Department of Respiratory and Critical Care Medicine,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China [3]Department of Respiratory and Critical Care Medicine,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China [4]Hepatic Disease and Tumor Interventional Treatment Center,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China [5]Fourth Department of Liver Disease,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China [6]Ultrasound and Functional Diagnosis Center,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China [7]Division of Clinical Epidemiology and Evidence-Based Medicine,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China [8]Department of Respiratory and Critical Care Medicine,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China [9]Beijing Institute of Hepatology,Department of Respiratory and Critical Care Medicine,Beijing Youan Hospital,Capital Medical University,Beijing 100069,Beijing,China

出　　处：《World Journal of Gastroenterology》2025年第15期60-78,共19页世界胃肠病学杂志(英文)

基　　金：Supported by the National Key Research and Development Program of China,No.2022YFC2305002;Beijing Natural Science Foundation,No.7232079;Middle-aged and Young Talent Incubation Programs(Clinical Research)of Beijing Youan Hospital,No.BJYAYY-YN2022-12,No.BJYAYY-YN2022-13,and No.BJYAYY-YN2022-01;the China Postdoctoral Science Foundation,No.2023M732410 and No.2024T170595.

摘　　要：BACKGROUND Patients with cirrhosis with hepatopulmonary syndrome(HPS)have a poorer prognosis.The disease has a subtle onset,symptoms are easily masked,clinical attention is insufficient,and misdiagnosis rates are high.AIM To compare the clinical characteristics of patients with cirrhosis,cirrhosis combined with intrapulmonary vascular dilatation(IPVD),and HPS,and to establish predictive models for IPVD and HPS.METHODS Patients with cirrhosis were prospectively screened at a liver-specialized university teaching hospital.Clinical information and blood samples were collected,and biomarker levels in blood samples were measured.Patients with cirrhosis were divided into three groups:Those with pure cirrhosis,those with combined IPVD,and those with HPS based on contrast-enhanced transthoracic echocardiography results and the pulmonary alveolar-arterial oxygen gradient values.Univariate logistic regression and Least Absolute Shrinkage and Selection Operator(LASSO)regression methods were utilized to identify risk factors for IPVD and HPS,and nomograms were constructed to predict IPVD and HPS.RESULTS A total of 320 patients were analyzed,with 101 diagnosed with IPVD,of whom 54 were diagnosed with HPS.There were statistically significant differences in clinical parameters among these three groups of patients.Among the tested biomarkers,sphingosine 1 phosphate,angiopoietin-2,and platelet-derived growth factor BB were significantly associated with IPVD and HPS in patients with cirrhosis.Following LASSO logistic regression screening,prediction models for IPVD and HPS were established.The area under the receiver operating characteristic curve for IPVD prediction was 0.792(95%confidence interval[CI]:0.737-0.847),and for HPS prediction was 0.891(95%CI:0.848-0.934).CONCLUSION This study systematically compared the clinical characteristics of patients with cirrhosis,IPVD,and HPS,and constructed predictive models for IPVD and HPS based on clinical parameters and laboratory indicators.These models showed good predictive value for IP

关 键 词：Liver cirrhosis Hepatopulmonary syndrome Prediction model Clinical parameters Biomarkers 

分 类 号：R575.2[医药卫生—消化系统]