肝硬化食管静脉曲张程度与实验室检测指标的相关性分析

肝脏 ›› 2022, Vol. 27 ›› Issue (10): 1096-1101.

肝硬化食管静脉曲张程度与实验室检测指标的相关性分析

吕莹, 蒋式骊, 吕靖, 赵长青, 邢枫, 顾宏图, 袁继丽, 刘成海, 刘平, 慕永平

201203 上海中医药大学附属曙光医院肝病二科,上海中医药大学肝病研究所,肝肾疾病病证教育部重点实验室,上海市中医临床重点实验室

收稿日期:2021-11-09 出版日期:2022-10-31 发布日期:2022-11-22
通讯作者: 慕永平,Email:ypmu8888@126.com;刘平,Email:liuliver@vip.sina.com;刘成海,Email:chenghailiu@hotmail.com
基金资助:
上海市临床重点专科建设项目(shslczdzk01201);上海市科学技术委员会科技创新项目(15411950500);国家自然科学基金面上项目(81874390)

An analysis on the correlation between esophageal varices degree and clinical indexes of liver cirrhosis

LV Ying, JIANG Shi-li, LV Jing, ZHAO Chang-qing, XING Feng, GU Hong-tu, YUAN Ji-li, LIU Cheng-hai, LIU Ping, MU Yong-ping

Department of Hepatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM); Institute of Liver Diseases, Shanghai University of TCM; Key Laboratory of Liver and Kidney Disease of the Ministry of Education; Clinical Key Laboratory of TCM of Shanghai, Shanghai 201203, China

Received:2021-11-09 Online:2022-10-31 Published:2022-11-22
Contact: MU Yong-ping, Email:ypmu8888@126.com; LIU Ping, Email:liuliver@vip.sina.com; LIU Cheng-hai, Email: chenghailiu@hotmail.com

摘要/Abstract

摘要： 目的分析肝硬化患者食管静脉曲张程度与实验室检测指标间的关系,为临床诊断及预后提供参考。方法采集2016年6月—2018年2月期间上海中医药大学附属曙光医院肝硬化科收治的175例确诊为肝硬化并行胃镜检查患者的临床信息,分析食管静脉曲张程度与实验室检测指标间的相关性。结果与无食管静脉曲张患者比较,有食管静脉曲张患者的红细胞(RBC)计数、血红蛋白(Hb)含量、血小板(PLT)计数、前白蛋白(PA)含量,胆碱酯酶(ChE)活性、凝血酶原活动度(PTA)、纤维蛋白原(FIB)含量等均显著降低(P<0.05或P<0.01);肝脏硬度值(kPa)显著增加(22.95 ± 9.85 vs. 18.22 ± 7.94, t=-2.815, P=0.006)。随着食管静脉曲张程度的增加,RBC、Hb、PLT、PA及ChE在无曲张(G0)、轻度曲张(G1)、中度曲张(G2)及重度曲张(G3)4组间差异有统计学意义(P<0.05),且G3组RBC、Hb、PLT、PA、ChE、PTA和FIB均显著低于G0组(P<0.05或P<0.01)。相关性分析显示,食管静脉曲张程度与RBC、Hb、PLT、PA、ChE、PTA和FIB均呈显著负相关(R²分别为0.8292、0.9219、0.9312、0.5064、0.8409、0.5547和 0.8504)。随着食管静脉曲张程度的增加,肝硬度值及CTP分级呈逐渐升高趋势,4组间比较差异有统计学意义(P<0.05),且食管静脉曲张程度与肝硬度值呈显著正相关(R²=0.9133)。结论肝硬化食管静脉曲张程度不仅与肝硬度值和CTP评分密切相关,且与外周血RBC、Hb、PLT、PA、ChE、PTA和FIB的水平密切相关,值得临床重视及深入发掘。

关键词: 肝硬化, 食管静脉曲张, 血常规, 肝功能, 凝血功能, 相关性分析

Abstract: Objective To analyze the relationship between the degree of esophageal varices and laboratory indexes of patients with liver cirrhosis, so as to provide reference for clinical diagnosis and prognosis. Methods The clinical information of 175 patients who were diagnosed with liver cirrhosis and underwent gastroscopy in the department of liver cirrhosis of Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine from June 2016 to February 2018 were collected, The correlation between the degree of esophageal varices and laboratory test indexes of these patients were analyzed. Results (1) Compared with patients without esophageal varices (EV), the levels of red blood cell (RBC), hemoglobin (Hb), platelet (PLT), prealbumin (PA), cholinesterase activity (ChE), prothrombin activity (PTA) and fibrinogen (FIB) in the EV group were significantly decreased (P<0.05 or P<0.01); whereas the iver stiffness was significantly increased (22.95 ± 9.85 vs. 18.22 ± 7.94, t=-2.815, P=0.006). (2) With the increase of the degree of EV, the levels of RBC, Hb, PLT, PA and ChE were significantly different among the four groups that were without varices (G0), mild varices (G1), moderate varices (G2) and severe varices (G3) (P<0.05), and RBC, Hb, PLT, PA, ChE, PTA and FIB in G3 group were reduced significantly than those in G0 group (P<0.05 or P<0.01). Correlation analysis showed that the degrees of EV were negatively correlated with the levels of RBC, Hb, PLT, PA, ChE, PTA and FIB (R² = 0.8292, R² = 0.9219, R² = 0.9312, R² = 0.5064, R² = 0.8409, R² = 0.5547, R² = 0.8504, respectively). (3) With the increase of the degrees of EV, the liver hardness value and CTP grade increased gradually. There were significant differences among the four groups (P<0.05), and the degrees of EV were positively correlated with the liver hardness values (R² = 0.9133). Conclusion The degrees of EV in liver cirrhosis are not only related to liver hardness values and CTP scores, but also related to the levels of RBC, Hb, PLT, PA, ChE, PTA and FIB in peripheral blood, which is worthy of clinical attention and -further exploration.

Key words: Cirrhosis, Esophageal varices, Routine blood test, Liver function, Coagulation function, Correlation analysis

吕莹, 蒋式骊, 吕靖, 赵长青, 邢枫, 顾宏图, 袁继丽, 刘成海, 刘平, 慕永平. 肝硬化食管静脉曲张程度与实验室检测指标的相关性分析[J]. 肝脏, 2022, 27(10): 1096-1101.

LV Ying, JIANG Shi-li, LV Jing, ZHAO Chang-qing, XING Feng, GU Hong-tu, YUAN Ji-li, LIU Cheng-hai, LIU Ping, MU Yong-ping. An analysis on the correlation between esophageal varices degree and clinical indexes of liver cirrhosis[J]. Chinese Hepatolgy, 2022, 27(10): 1096-1101.

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