Correlation study between hepatic venous pressure gradient after balloon-occluded retrograde transvenous obliteration and esophageal variceal rupture and bleeding in patients with liver cirrhosis
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 was76.19%,and specificity was82.19%,with cutoff value The sensitivity of HVPG level after BRTO treatment was 76.19%,the specificity was 82.19%,and the cut-off value was 15.54 mmHg.Conclusion:Determination of postoperative HVPG level after BRTO treatment of GV can provide an early warning of the risk of EVB in patients with cirrhosis,and early targeted intervention.
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