The Clinical Value of Liver-spleen Stiffness Combined with Portal Vein Width in Predicting the Risk of Rupture and Bleeding of Esophagogastric Varices in Alcoholic Cirrhosis
Objective To investigate the clinical value of measuring liver-spleen stiffnessin con-junction with portal vein width in predicting the risk of rupture and bleeding of esophagogastric varices in patients with alcoholic cirrhosis(AC).Methods The clinical records of 200 AC patients admitted to the Fifth People's Hospital of Ganzhou City between January 2020 and December 2022 were retrospectively analyzed.Based on the Endoscopic Classification Criteria for Esophageal Varices,patients were categorized into four groups:non-varicose group(n=41),mild varicose group(n=43),moderate varicose group(n=61),and severe varicose group(n=55),and they were all subjected to e-gastroscopy,liver and spleen hardness and abdominal ultrasound to com-pare their liver stiffness measurement(LSM),spleen stiffness measurement(SSM),spleen thick-ness and portal vein width levels.The patients were followed up for a period of 18 months and di-vided into the bleeding group(n=116)and the non-bleeding group(n=84)according to the pres-ence or absence of ruptured esophagogastric variceal hemorrhage during the follow-up period.The levels of LSM,SSM values,and portal vein width of the 2 groups were compared,anda ROC risk assessment model was established to evaluate the diagnostic efficacy of liver-spleen stiffness,por-tal vein width,and the combination of the two.Results The levels of LSM,SSM,spleen thick-ness,and portal vein width in the severe varicose group were higher than those in the mild and moderate varicose groups(P＜0.05);the levels of LSM,SSM,and portal vein width in the bleed-ing group were significantly increased compared with those in the non-bleeding group(P＜0.001);and the results of the ROC curve analysis showed that the risk assessment model of liver-spleen stiffness combined with portal vein width had the highest AUC value of 0.983,and the sen-sitivity and specificity were 98.27％and 83.62％,respectively.Conclusion LSM,SSM,spleen thickness,and portal vein width can all gradually increase with the aggravation of esophagogastric varices in patients with AC.The combination of liver and spleen stiffness and portal vein width may have a higher clinical valuein predicting the risk of rupture and bleeding of esophageal varices than the use of LSM,SSM,or portal vein width alone in AC patients.
万方数据
维普
