中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2015年
5期
339-342
,共4页
李勤涛%蒋力%张珂%黄容海%鲁岩%郭立民%赫嵘%贾哲%李宝亮
李勤濤%蔣力%張珂%黃容海%魯巖%郭立民%赫嶸%賈哲%李寶亮
리근도%장력%장가%황용해%로암%곽립민%혁영%가철%리보량
肝硬化%食管静脉曲张%高血压,门静脉%诊断%logistic回归模型
肝硬化%食管靜脈麯張%高血壓,門靜脈%診斷%logistic迴歸模型
간경화%식관정맥곡장%고혈압,문정맥%진단%logistic회귀모형
Liver cirrhosis%Esophageal varices%Hypertension,portal%Diagnosis%Logistic model
目的 分析预测肝炎肝硬化患者食管静脉曲张的无创指标,并建立模型预测食管静脉曲张程度. 方法 根据胃镜检查结果将294例肝炎肝硬化门静脉高压症患者按食管静脉曲张程度分为两组,即无或轻度曲张组、中重度曲张组.对肝脏硬度值、血小板计数、脾脏厚度、血小板计数/脾脏厚度比值、门静脉直径、门静脉血流速度、Child-Pugh评分进行单因素分析和logistic回归分析,筛选出可以有效预测食管静脉曲张及其程度的无创指标,并在此基础上构建预测模型.计量资料采用t检验,计数资料应用x2检验,多因素分析采用logistic回归分析,应用受试者工作特征曲线分析方法评价模型的诊断价值并确定界值.结果 建立的无创预测模型受试者运行曲线显示,ROC曲线下面积为0.990,以积分0.898为界值,诊断的敏感性为96.5％,特异性为99.2％. 结论 由肝脏硬度、脾脏厚度、血小板计数、血小板计数/脾脏厚度、Child-Pugh评分五个无创指标建立的预测模型预测食管静脉曲张准确、敏感,具有一定临床应用价值.
目的 分析預測肝炎肝硬化患者食管靜脈麯張的無創指標,併建立模型預測食管靜脈麯張程度. 方法 根據胃鏡檢查結果將294例肝炎肝硬化門靜脈高壓癥患者按食管靜脈麯張程度分為兩組,即無或輕度麯張組、中重度麯張組.對肝髒硬度值、血小闆計數、脾髒厚度、血小闆計數/脾髒厚度比值、門靜脈直徑、門靜脈血流速度、Child-Pugh評分進行單因素分析和logistic迴歸分析,篩選齣可以有效預測食管靜脈麯張及其程度的無創指標,併在此基礎上構建預測模型.計量資料採用t檢驗,計數資料應用x2檢驗,多因素分析採用logistic迴歸分析,應用受試者工作特徵麯線分析方法評價模型的診斷價值併確定界值.結果 建立的無創預測模型受試者運行麯線顯示,ROC麯線下麵積為0.990,以積分0.898為界值,診斷的敏感性為96.5％,特異性為99.2％. 結論 由肝髒硬度、脾髒厚度、血小闆計數、血小闆計數/脾髒厚度、Child-Pugh評分五箇無創指標建立的預測模型預測食管靜脈麯張準確、敏感,具有一定臨床應用價值.
목적 분석예측간염간경화환자식관정맥곡장적무창지표,병건립모형예측식관정맥곡장정도. 방법 근거위경검사결과장294례간염간경화문정맥고압증환자안식관정맥곡장정도분위량조,즉무혹경도곡장조、중중도곡장조.대간장경도치、혈소판계수、비장후도、혈소판계수/비장후도비치、문정맥직경、문정맥혈류속도、Child-Pugh평분진행단인소분석화logistic회귀분석,사선출가이유효예측식관정맥곡장급기정도적무창지표,병재차기출상구건예측모형.계량자료채용t검험,계수자료응용x2검험,다인소분석채용logistic회귀분석,응용수시자공작특정곡선분석방법평개모형적진단개치병학정계치.결과 건립적무창예측모형수시자운행곡선현시,ROC곡선하면적위0.990,이적분0.898위계치,진단적민감성위96.5％,특이성위99.2％. 결론 유간장경도、비장후도、혈소판계수、혈소판계수/비장후도、Child-Pugh평분오개무창지표건립적예측모형예측식관정맥곡장준학、민감,구유일정림상응용개치.
Objective To analyze the non-invasive indexes for predicting esophageal varices (EV) in liver cirrhosis,and to establish a model for predicting the degree of EV.Methods A total of 294 patients with liver cirrhosis and portal hypertension were divided into the following groups according to EV grade as assessed by endoscopy:non-EV and grade Ⅰ EV,grade Ⅱ EV and grade Ⅲ EV.The non-invasive EV predictive measures of liver stiffness (LS),platelet (PLT) count,spleen thickness (ST),PLT/ST ratio,portal vein diameter,portal vein flow velocity and Child-Pugh score (CPS) were assessed by univariate analysis and multivariate logistic regression analysis,and used to generate a predictive model.The t-test,chi-square test,logistic analysis and receiver operating characteristic (ROC) curve were used in statistical analyses.Results The area under the ROC for the new model was 0.990.The best cutoff value for the score was 0.898,as defined from the ROC.The sensitivity of the model was 96.5％,and the specificity was 99.2％.Conclusions The model for predicting EV was composed ofLS,PLT count,ST,PLT/ST and CPS,which was accurate and sensitive,and could be used to predict EV in clinic.
