摘要
目的:分析肝血流超声参数、血清胰岛素样生长因子结合蛋白-3(IGFBP-3)、微小RNA-9a-5p(miR-9a-5p)水平联合检测在肝硬化食管胃底静脉曲张破裂出血(EGVB)患者再出血诊断中的效能.方法:选取 2018 年 10 月至 2022 年 3 月该院收治的 124 例肝硬化EGVB患者进行横断面研究,依据治疗后6个月是否发生再出血将其分为出血组70例与未出血组54例.比较两组肝血流超声参数[门静脉内径(PVD)、肝静脉减振指数(HV-DI)、门静脉血流速度(PVV)]、血清IGFBP-3和miR-9a-5p水平,绘制受试者工作特征(ROC)曲线分析肝血流超声参数、血清IGFBP-3、miR-9a-5p水平联合检测在肝硬化EGVB患者再出血诊断中的效能.结果:治疗后 1 个月,两组PVD、HV-DI、血清IGFBP-3、miR-9a-5p水平低于治疗前,但出血组高于未出血组;两组PVV均高于治疗前,但出血组低于未出血组,差异有统计学意义(P<0.05);经ROC曲线分析结果显示,治疗后 1 个月PVD、HV-DI、PVV、IGFBP-3、miR-9a-5p水平单项及联合检测诊断肝硬化EGVB患者再出血的曲线下面积分别为 0.760、0.761、0.764、0.753、0.780、0.930,且联合检测诊断肝硬化EGVB治疗后再出血的效能高于五者单项检测.结论:肝血流超声参数、血清IGFBP-3、miR-9a-5p水平联合检测诊断肝硬化EGVB患者再出血的效能高于五者单项检测.
Abstract
Objective:To analyze efficiency of combined detection of liver blood flow ultrasound parameters,serum insulin-like growth factor binding protein-3(IGFBP-3)and microRNA-9a-5p(miR-9a-5p)levels in diagnosis of rebleeding in patients with liver cirrhosis and esophagogastric variceal bleeding(EGVB).Methods:A cross-sectional study was conducted on 124 liver cirrhosis patients with EGVB admitted to the hospital from October 2018 to March 2022.According to whether rebleeding occurred within 6 months after the treatment,they were divided into bleeding group(70 cases)and non-bleeding group(54 cases).The levels of liver blood flow ultrasound parameters[portal vein diameter(PVD),hepatic vein damping index(HV-DI),portal vein blood flow velocity(PVV)],the serum IGFBP-3 level and the miR-9a-5p level were compared between the two groups.The receiver operating characteristic curve(ROC)was drawn to analyze the efficiency of combined detection of liver blood flow ultrasound parameters,serum IGFBP-3 and miR-9a-5p levels in the diagnosis of rebleeding in patients with liver cirrhosis and EGVB.Results:1 month after the treatment,the levels of PVD,HV-DI and serum IGFBP-3,miR-9a-5p in the two groups were lower than those before the treatment,but those in the bleeding group were higher than those in the non-bleeding group;the PVV levels of the two groups were higher than those before the treatment,but that in the bleeding group was lower than that in the non-bleeding group,and the differences were statistically significant(P<0.05).The ROC curve analysis showed that the area under the curve of single and combined detection of PVD,HV-DI,PVV,IGFBP-3 and miR-9a-5p levels in the diagnosis of rebleeding in patients with liver cirrhosis and EGVB 1 month after the treatment were 0.760,0.761,0.764,0.753,0.780 and 0.930,respectively,and the efficiency of combined detection was higher than that of single detection.Conclusions:The efficiency of combined detection of liver blood flow ultrasound parameters,serum IGFBP-3 and miR-9a-5p levels in the diagnosis of rebleeding in the patients with liver cirrhosis and EGVB is higher than that of single detection of the five.
维普
万方数据