The application and influencing factors of endoscopic ultrasound in measuring portal vein pressure gradient in patients with liver cirrhosis and portal hypertension

Abstract

Abstract: Objective To explore the application and influencing factors of endoscopic ultrasound in the measurement of portal pressure gradient of patients with liver cirrhosis and portal hypertension.Methods A total of 122 patients with suspected cirrhosis and portal hypertension admitted to Beijing You'an hospital from January 2022 to October 2023 were selected as the study subjects. The general information of the study subjects, measured values of portal vein pressure gradient (PPG), hepatic vein pressure gradient (HVPG), and surgical related indicators were recorded. The measurement values of PPG and HVPG in patients with and without cirrhosis portal hypertension, and the measurement values of PPG and HVPG in cirrhotic patients with different portal hypertension degrees and liver function levels wer compared, and the diagnostic value of PPG values for cirrhosis portal hypertension and its severity were analyzed through the area under the curve (AUC) of receiver operating curve (ROC).Results The surgical success rate of PPG value guided by endoscopic ultrasound in this study was 98.4%. The PPG value measured by EUS method was (18.74±10.1) mmHg, while the HVPG value measured by jugular vein puncture was (19.06±8.2) mmHg (t=0.269, P=0.788), There was no significant difference between the values of the two groups. The PPG value of (10.7±3.3) mmHg in the group without portal hypertension was significantly lower than that of (20.7±10.5) mmHg in the group with portal hypertension (t=5.646, P=0.000). The PPG value of (16.2±4.1)mmHg in the mild portal hypertension group was significantly lower than that of (25.2±7.6) mmHg in the severe portal hypertension group, (t=7.230, P=0.000). The PPG values of children with liver function grades A, B, and C were (16.2±8.3) mmHg, (18.9±7.3) mmHg, and (17.3±8.8) mmHg (t=1.657, P=0.195), respectively. ROC curve analysis shows that PPG measurement values have good diagnostic values for diagnosing portal hypertension (0.981, P=0.000) and the severity of portal hypertension (0.947, P=0.000).Conclusion For the diagnosis of patients with liver cirrhosis and portal hypertension, ultrasound guided PPG measurement can be used, instead of HVPG measurement, which provide a new mean for the diagnosis and evaluation portal hypertension in patients with liver cirrhosis.

Key words: Endoscopic ultrasound, Liver cirrhosis, Portal vein pressure gradient, Portal hypertension, Application

MA Ying-hui, LIN He, WANG Lei, ZHANG Yu, ZHAO Ya-li. The application and influencing factors of endoscopic ultrasound in measuring portal vein pressure gradient in patients with liver cirrhosis and portal hypertension[J]. Chinese Hepatolgy, 2025, 30(3): 301-304.

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