门静脉血流动力学联合RLR评估乙型肝炎肝硬化并发食管静脉曲张效能研究

摘要/Abstract

摘要： 目的探讨门静脉血流参数联合红细胞分布宽度与淋巴细胞比值(RLR)对乙型肝炎肝硬化并发食管静脉曲张的诊断价值。方法选取2021年1月至2024年1月秦皇岛市中医医院收治的乙型肝炎肝硬化患者126例。所有患者均接受内镜检查,将发生食管静脉曲张的患者设为观察组,其他患者为对照组。收集患者临床资料,经彩色多普勒超声检测患者门静脉血流,并比较两组的RLR。通过logistic回归分析探讨乙型肝炎肝硬化患者的门静脉血流参数及RLR与发生食管静脉曲张的关系,并采用ROC曲线评估诊断效能。结果本研究中,患者发生食管静脉曲张占比为61.11%(77/126)。观察组和对照组的门静脉血流速度分别为(9.51±1.68)cm/s、(12.97±2.21)cm/s,观察组低于对照组;观察组的血管内径、血流量和RLR分别为(15.02±2.71)mm、(1 099.84±296.75)mL/min、(18.12±2.94),均高于对照组(P<0.05);血管内径、血流量和RLR增加,而血流速度降低的患者,并发食管静脉曲张的风险增加(P<0.05)。ROC曲线显示,门静脉血流参数联合RLR诊断患者食管静脉曲张的准确度为0.981 (0.963~0.999),灵敏度为90.9%,特异度为95.9%。结论门静脉血流参数联合RLR诊断对乙型肝炎肝硬化并发食管静脉曲张有较高的诊断价值。

关键词: 彩色多普勒超声, 门静脉血流动力学, 乙型肝炎肝硬化, 食管静脉曲张

Abstract: Objective To explore the diagnostic value of hemodynamic parameters of portal vein combined with red blood cell distribution width to lymphocyte ratio (RLR) in hepatitis B-related liver cirrhosis complicated by esophageal varices (EV). Methods A total of 126 patients with hepatitis B-related liver cirrhosis admitted to Qinhuangdao Traditional Chinese Medicine Hospital from January 2021 to January 2024 were selected. All patients underwent endoscopic examination. Patients with EV were designated as the observation group, and patients without the condition was referred as the control group. The clinical data of all patients were collected, and the portal vein blood flow was assessed using color Doppler ultrasound. The RLR was then compared between the two groups. Logistic regression analysis was conducted to explore the relationship between portal hemodynamic parameters and RLR and the occurrence of esophageal varices. The diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves method. Results Among the 126 patients with hepatitis B-related liver cirrhosis, 77 (61.11%) developed EV. The portal vein blood flow velocity in the observation group was significantly lower than those in the control group [(9.51 ± 1.68) cm/s vs. (12.97 ± 2.21) cm/s]. The portal vein diameter, blood flow volume, and RLR in the observation group were significantly greater than those in the control group [(15.02 ± 2.71) mm vs. (13.56 ± 2.52) mm; (1 099.84 ± 296.75) mL/min vs. (792.32 ± 180.92) mL/min; (18.12 ± 2.94) vs. (13.86 ± 2.53)], respectively. Logistic regression analysis showed that an increased portal vein diameter, blood flow volume, RLR, and reduced blood flow velocity were associated with a higher risk of developing EV. ROC curve analysis indicated that the combined use of portal hemodynamic parameters and RLR had a diagnostic accuracy of 0.981 (0.963~0.999), sensitivity of 90.9%, and specificity of 95.9%. Conclusion The combined evaluation of portal hemodynamic parameters and RLR has a high diagnostic value for EV in hepatitis B-related liver cirrhosis.

Key words: Color doppler ultrasound, Portal hemodynamics, Hepatitis B-related liver cirrhosis, Esophageal varices

王海玉, 张美喜, 张志博, 李静, 王倩. 门静脉血流动力学联合RLR评估乙型肝炎肝硬化并发食管静脉曲张效能研究[J]. 肝脏, 2026, 31(2): 187-190.

WANG Hai-yu, ZHANG Mei-xi, ZHANG Zhi-bo, LI-Jing, WANG Qian. A study on the diagnostic value of portal hemodynamics combined with red blood cell distribution width to lymphocyte ratio (RLR) in evaluating esophageal varices in hepatitis B-related liver cirrhosis[J]. Chinese Hepatolgy, 2026, 31(2): 187-190.

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