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

Abstract

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

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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