脏厚度加上血小板可以有效和安全地选肝硬化患者的高风险静脉
Fengbin Zhang1,2, Yonghe Zhou3, Xin Li3
1Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin 300070, China.
Diagnostics (Basel, Switzerland)
|October 28, 2023
概括
脏厚度和血小板计数为查肝硬化患者高风险静脉瘤的标准方法提供了一个方便的替代方案,可能减少对侵入性手术的需要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 医疗成像医学成像
- 胃肠病学 胃肠病学
背景情况:
- 指导方针建议进行肝脏和硬度测量,以排除肝硬化患者的高风险静脉动脉 (HRV).
- 这些硬度测量的常规执行在大多数初级医院是不可行的.
- 需要更容易获得的指标来进行HRV查.
研究的目的:
- 确定用于查肝硬化患者高风险静脉瘤 (HRV) 的方便指标.
- 评估脏厚度 (ST) 和血小板计数 (PLT) 作为HRV预测指标的有效性.
- 将ST+PLT的性能与现有的标准比较,例如Baveno VI和硬度测量 (SSM).
主要方法:
- 招募了213名肝硬化患者的培训队列 (TC) 和65名初级胆道肝硬化患者的验证队列 (VC).
- 分析了包括硬度测量 (SSM),肝硬度测量 (LSM),厚度 (ST) 和血小板计数 (PLT) 在内的指标.
- 评估了ST+PLT在检测HRV时避免食道胃管腺镜 (EGD) 的能力,并与Baveno VI和SSM+PLT进行了比较.
主要成果:
- 脏厚度 (ST) 和血小板计数 (PLT) 被确定为HRVs的独立风险指标.
- 在培训队列中,ST+PLT避免了35.7%的EGD,HRV遗漏率为2.4%,表现优于Baveno VI标准.
- 在验证队列中,ST+PLT安全地节省了24.6%的EGD,类似于Baveno VI标准.
结论:
- 脏厚度和血小板计数 (ST+PLT) 的结合是一种可行的和方便的模型,用于排除高风险的静脉动脉,当脏硬度测量不是常规可用的.
- 在排除HRV方面,ST+PLT表现优于Baveno VI标准,但效果略低于SSM+PLT.
- 这种模型提供了一种切实可行的替代方案,可以减少肝硬化患者不必要的食道胃管腺镜检查.
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