摘要
目的探讨肝硬化患者食管静脉曲张的临床预测方法。方法回顾性分析126例肝硬化失代偿期患者的临床资料，包括胃镜检查所见食管静脉曲张程度，腹部超声测量所得脾静脉内径（SV）、门静脉内径（PV）、腹水、脾脏长度和厚度，计算脾脏指数（Si），以及Pt、凝血酶原时间（PT）和肝功能指标等。结果95例肝硬化失代偿期患者有食管静脉曲张，其中42例为重度食管静脉曲张，食管静脉曲张患者sI和P￡两项指标与无食管静脉曲张患者比较差异有统计学意义，Logistic回归分析显示SI和Pt是食管静脉曲张的预测因素，当SI≥66．9cm^2，Pt≤89．0×10^9／L时，其阳性预测值分别为97．4％和96．5％，阴性预测值分别为5514％和59．8％；而SI是重度食管静脉曲张的预测因素，当SI≥82．6cm^2时，其阳性预测值为89．2％，阴性预测值为75．4％。结论SI和Pt可以较好地预测食管静脉曲张，SI是预测重度食管静脉曲张的临床指标，两者具有无创、简便等特点，可用于肝硬化失代偿期患者食管静脉曲张及其程度的预测。
Objective To study whether clinics/variables could be used to predict the presence of esophageal varices（EV）. Methods One hundred and twenty-six patients with decompensated liver cirrhosis were enrolled： Upper endoscopy was performed to identify the EV. The spleen vein （SV）, potful vein （PV）, spleen index（SI）, ascites was determined by ultrasonography. Platelet count（Pt）, prothrombin time （PT） and liver function was determined. Results Ninety-five patients with EV, and 42 patients with severe EV. Patients with EV had significant larger SI and lower Pt. Pt and SI were predictive factors for the presence of EV. When SI ≥ 66.9 cm^2 and Pt ≤ 89.0 × 10^9/L, they had a positive predictive value of 97.4 % and 96.5%, and a negative predictive value of 55.4% and 59.8%, respectively. SI was the only predictive factor for the presence of severe EV. When SI ≥ 82.6 cm^2, it had a positive and negative predictive value of 89.2% and 75.4%. Conclusions Pt and SI are predictive factors for the presence of EV. SI is the only predictive factor for the presence of severe EV. Non-invasive factors SI and Pt can be used to predict the EV in patients with decompensated liver cirrhosis.
出处
《中国医师进修杂志（内科版）》
2008年第10期29-32,共4页
Chinese Journal of Postgraduates of Medicine
关键词
肝硬化
食管和胃静脉曲张
血小板计数
脾脏指数
Liver cirrhosis
Esophageal and gastric varices
Platelet count
Spleen index
