LSPS和GBWT对食管胃静脉曲张内镜下治疗后出血的预测价值

摘要/Abstract

摘要： 目的探讨肝硬度×脾脏直径/血小板比率(LSPS)和胆束壁厚度(GBWT)对食管胃静脉曲张内镜下治疗后出血的预测价值。方法纳入2020年1月至2024年4月萍乡市第二人民医院接受内镜下食管胃静脉曲张套扎术、硬化剂注射术、组织黏合剂注射术治疗的乙型肝炎后肝硬化食管胃静脉曲张患者90例,分为出血组22例和未出血组68例。对比两组的年龄、GBWT、血小板、ALT、血红蛋白、肌酐、LSPS、CTP评分。logistic回归分析内镜下治疗后出血的独立危险因素,以受试者工作特性曲线面积(AUC)评价LSPS和GBWT对预测食管胃静脉曲张内镜下治疗后出血的价值。结果两组患者的LSPS、GBWT比较差异有统计学意义(P<0.01)。二分类logistic 回归分析示两组患者的LSPS、GBWT与食管胃静脉曲张内镜下治疗后出血独立相关(P<0.05)。LSPS、GBWT预测食管胃静脉曲张内镜下治疗后出血的AUC分别为0.961、0.898,最佳截断点分别为11、2.5,敏感度分别为0.818、0.864,特异度分别为0.971、0.779。结论 LSPS、GBWT为食管胃静脉曲张内镜下治疗后出血的独立危险因素,具有较高的预测价值。

关键词: LSPS, GBWT, 预测价值, 食管胃静脉曲张, 乙型肝炎后肝硬化

Abstract: Objective To investigate the predictive value of Liver stiffness-spleen diameter-to-patelet ratio score (LSPS) combined with Gall bladder wall thickeness (GBWT) for esophageal and gastric varices bleeding post endoscopic treatment.Methods A total of 90 patients with hepatitis B-related cirrhosis and esophagogastric varices who received endoscopic variceal ligation, sclerosing agent injection, and tissue adhesive injection during hospitalization in the Second People's Hospital of Pingxiang from January 2020 to April 2024 were selected. According to whether bleeding occurred post treatment, they were divided into a bleeding group (22 cases) and a non-bleeding group (68 cases). The age, GBWT, platelet, alanine aminotransferase (ALT), hemoglobin, creatinine, LSPS, and CTP scores of the two groups were observed and compared. Through univariate analysis of the differences in the above indicators, variables with P<0.05 were included in binary logistic regression analysis to screen out independent risk factors of bleeding after endoscopic treatment. The receiver operating characteristic curve (ROC) was drawn, and the value of LSPS combined with GBWT in predicting esophagogastric varices bleeding after endoscopic treatment was evaluated according to the area under the ROC curve (AUC), and to determine the best cut-off point, sensitivity and specificity for predicting bleeding after endoscopic treatment of esophagogastric varices.Results Univariate analysis showed that there were significant differences in LSPS and GBWT between the two groups (P<0.01). Binary logistic regression analysis showed that LSPS and GBWT of the two groups were independently associated with bleeding after endoscopic treatment of esophageal and gastric varices (P<0.05). ROC analysis showed that the AUC of LSPS and GBWT in the two groups were 0.961 and 0.898, the best cut-off points were 11 and 2.5, the sensitivity were 0.818 and 0.864, and the specificity were 0.971 and 0.779, respectively.Conclusion LSPS and GBWT are independent risk factors for bleeding post endoscopic treatment of esophagogastric varices. LSPS combined with GBWT has a higher predictive value for bleeding after endoscopic treatment.

Key words: LSPS, GBWT, Predictive value, Esophageal and gastric varices, Cirrhosis after hepatitis B

李霞, 曾圆, 左娜, 李佳萦, 刘溢. LSPS和GBWT对食管胃静脉曲张内镜下治疗后出血的预测价值[J]. 肝脏, 2025, 30(3): 316-318.

LI Xia, ZENG Yuan, ZUO Na, LI Jia-ying, LU Yi. The predictive value of LSPS combined with GBWT for esophageal and gastric varices bleeding post endoscopic treatment[J]. Chinese Hepatolgy, 2025, 30(3): 316-318.

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