Chinese Hepatolgy ›› 2024, Vol. 29 ›› Issue (8): 934-938.

• Liver Fibrosis & Cirrhosis • Previous Articles     Next Articles

Analysis of predictive value of serological indicators combined with Child-Pugh score on rebleeding after EVL in patients with liver cirrhosis complicated with esophageal varices bleeding

HU Jing1, YI Ting-zhuang2, NONG Xin-lei3, WANG Tong-hua1   

  1. 1. Department of Gastroenterology,Affiliated Hospital of Youjiang Ethnomedicine College, Baise,Guangxi 533000,China;
    2. Department of Tumor Radiotherapy,Affiliated Hospital of Youjiang Ethnomedicine College, Baise,Guangxi 533000,China;
    3. Department of Gastroenteroscopy,Affiliated Hospital of Youjiang Ethnomedicine College, Baise,Guangxi 533000,China
  • Received:2023-08-28 Online:2024-08-31 Published:2024-09-30
  • Contact: WANG Tong-hua,Email:wangtonghua420@163.com

Abstract: Objective To analyze the predictive value of serological indicators combined with Child-Pugh score on rebleeding after esophageal variceal ligation (EVL) in patients with liver cirrhosis complicated with esophageal varices bleeding (EVB). Methods 97 patients with liver cirrhosis and EVB who received EVL treatment in our hospital between September 2020 and September 2022 were enrolled, and divided into rebleeding group (n=31) and non-rebleeding group (n=66) according to whether rebleeding occurred within 6 months after EVL. Clinical data of patients were collected. Multivariate logistic regression analysis was used to analyze the related factors affecting rebleeding after EVL in patients with liver cirrhosis and EVB, and the predictive value of serological indicators combined with Child-Pugh score on rebleeding after EVL in patients with liver cirrhosis and EVB was analyzed by receiver operating characteristic curve (ROC) and area under the curve (AUC). Results Multivariate logistic regression analysis showed that Child-Pugh grading (OR=2.259, 95%CI: 1.040-4.909), portal vein diameter (OR=2.933, 95%CI: 1.509-5.700), APTT (OR=1.451, 95%CI: 1.158-1.817), PT (OR=1.982, 95%CI: 1.120-3.506) and Child-Pugh score (OR=3.834, 95%CI: 1.849-7.950) were the risk factors of rebleeding after EVL in patients with liver cirrhosis and EVB, and PLT (OR=0.585, 95%CI: 0.369-0.927) and Alb (OR=0.824, 95%CI: 0.723-0.940) were the protective factors effecting rebleeding after EVL in patients with liver cirrhosis and EVB (P<0.05). The results of ROC showed that the AUCs of PLT, APTT, PT, Alb, Child-Pugh score and the combination of the above indicators in predicting rebleeding after EVL in patients with liver cirrhosis and EVB were 0.800, 0.671, 0.729, 0.721, 0.789 and 0.916 respectively, and the sensitivities were 83.9%, 64.5%, 71.0%, 77.4%, 80.6% and 87.1%, and the specificities were 63.6%, 68.2%, 75.8%, 66.7%, 65.2% and 74.2% respectively. Conclusion Child-Pugh grading, portal vein diameter, PLT, APTT, PT, Alb and Child-Pugh score are the influencing factors of rebleeding after EVL in patients with liver cirrhosis complicated with EVB. Serological indicators of PLT, APTT, PT and Alb combined with Child-Pugh score can help to enhance the predictive value on rebleeding after EVL in patients with liver cirrhosis complicated with EVB.

Key words: Serological indicators, Liver cirrhosis, Esophageal varices bleeding, Esophageal variceal ligation, Rebleeding, Predictive value