中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2015年
1期
50-54
,共5页
刘丙菊%吴利春%王广川%冯华%胡锦华%崔屹%张春清
劉丙菊%吳利春%王廣川%馮華%鬍錦華%崔屹%張春清
류병국%오리춘%왕엄천%풍화%호금화%최흘%장춘청
肝硬化%高血压,门静脉%静脉压,肝%食管和胃静脉曲张%手术后出血
肝硬化%高血壓,門靜脈%靜脈壓,肝%食管和胃靜脈麯張%手術後齣血
간경화%고혈압,문정맥%정맥압,간%식관화위정맥곡장%수술후출혈
Liver cirrhosis%Hypertension,portal%Hepatic venous pressure%Esophageal and gastric varices%Postoperative hemorrhage
目的 探讨肝静脉压力梯度(HVPG)预测内镜下食管静脉曲张套扎术(EVL)后早期再出血的应用价值.方法 研究有肝硬化食管静脉曲张出血史、EVL前行HVPG测定患者105例.收集其住院期间HVPG值、内镜下表现及EVL术后2周内是否出血及其他严重并发症等.应用x2检验、秩和检验、logiStic回归模型的假设检验及受试者工作特征曲线(ROC)分析进行统计学处理. 结果 经统计学分析,只有HVPG是EVL术后早期再出血的独立危险因素.对HVPG关于EVL术后早期再出血行ROC分析,得出曲线下面积(AUC)为0.866,当HVPG≥16 mmHg时,AUC为0.838,有一定准确性,其敏感性为90.9％,特异性为76.6％.结论 HVPG是影响EVL术后早期再出血的独立危险因素.HVPG≥16 mmHg作为预测EVL术后早期再出血的阈值,具有一定准确性、敏感性及特异性.
目的 探討肝靜脈壓力梯度(HVPG)預測內鏡下食管靜脈麯張套扎術(EVL)後早期再齣血的應用價值.方法 研究有肝硬化食管靜脈麯張齣血史、EVL前行HVPG測定患者105例.收集其住院期間HVPG值、內鏡下錶現及EVL術後2週內是否齣血及其他嚴重併髮癥等.應用x2檢驗、秩和檢驗、logiStic迴歸模型的假設檢驗及受試者工作特徵麯線(ROC)分析進行統計學處理. 結果 經統計學分析,隻有HVPG是EVL術後早期再齣血的獨立危險因素.對HVPG關于EVL術後早期再齣血行ROC分析,得齣麯線下麵積(AUC)為0.866,噹HVPG≥16 mmHg時,AUC為0.838,有一定準確性,其敏感性為90.9％,特異性為76.6％.結論 HVPG是影響EVL術後早期再齣血的獨立危險因素.HVPG≥16 mmHg作為預測EVL術後早期再齣血的閾值,具有一定準確性、敏感性及特異性.
목적 탐토간정맥압력제도(HVPG)예측내경하식관정맥곡장투찰술(EVL)후조기재출혈적응용개치.방법 연구유간경화식관정맥곡장출혈사、EVL전행HVPG측정환자105례.수집기주원기간HVPG치、내경하표현급EVL술후2주내시부출혈급기타엄중병발증등.응용x2검험、질화검험、logiStic회귀모형적가설검험급수시자공작특정곡선(ROC)분석진행통계학처리. 결과 경통계학분석,지유HVPG시EVL술후조기재출혈적독립위험인소.대HVPG관우EVL술후조기재출혈행ROC분석,득출곡선하면적(AUC)위0.866,당HVPG≥16 mmHg시,AUC위0.838,유일정준학성,기민감성위90.9％,특이성위76.6％.결론 HVPG시영향EVL술후조기재출혈적독립위험인소.HVPG≥16 mmHg작위예측EVL술후조기재출혈적역치,구유일정준학성、민감성급특이성.
Objective To investigate the predictive value of hepatic venous pressure gradient (HVPG) for early bleeding after esophageal variceal ligation (EVL) by analyzing the differences in HVPG in patients with and without post-EVL bleeding.Methods The medical records of patients who had been diagnosed with cirrhosis and esophageal varices and who had pre-EVL HVPG measurement data were surveyed.The study population included 105 patients from October 2010 to March 2014.Data of HVPG value,previous treatment history,endoscopic manifestation,and whether bleeding and serious complications occurred within 2 weeks after the ligation procedure were investigated as independent risk factors.Statistical methods included the chi-square test and Wilcoxon test,logistic regression modeling and receiver operating characteristic (ROC) analysis using the SPSS software version 16.Results Only HVPG value was identified as an independent risk factor of early bleeding after EVL.According to the ROC analysis,the area under the curve (AUC) of HVPG for early bleeding after EVL was 0.866; when HVPG was ≥ 16 mmHg,AUC was 0.838.The sensitivity was 90.9％ and the specificity was 76.4％.Conclusion HVPG is an independent factor of early bleeding after EVL and when HVPG cut-off value of ≥ 16 mmHg is used the predictive ability has certain accuracy and high sensitivity and specificity.
