预测食道水和需要治疗的水在补偿的晚期慢性肝病中
Ragesh B Thandassery1,2, Nimy John3,4,5, Fares A Mashal3,4
1Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA. rthandassery@uams.edu.
Digestive diseases and sciences
|July 3, 2025
概括
巴文诺VI标准 (BC) 和扩展BC (EBC) 有效地识别了补偿晚期慢性肝病 (cACLD) 的患者,这些患者需要治疗食道静脉 (EV). 这些非侵入性得分可以帮助患者免受不必要的内镜检查,同时保持高准确度.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 诊断的准确性 诊断的准确性
背景情况:
- 补偿性晚期慢性肝病 (cACLD) 携带胃食道静脉的风险.
- 非侵入性评分系统旨在识别患有cACLD的患者,这些患者需要对临床显著的门高血压 (CSPH) 进行内镜查.
- 对于预测CSPH,特别是食道静脉 (EV) 和需要治疗的静脉 (VNT) 的这些得分的准确性,对比数据有限.
研究的目的:
- 直接比较各种非侵入性评分系统的诊断准确性,以预测CSPH (EV和VNT) 在cACLD患者中.
- 评估Baveno VI标准 (BC) 和扩展的BC (EBC) 的能力,以免患者接受食道胃管腺镜检查 (EGD).
主要方法:
- 评估了一组cACLD患者的队列.
- 对比了Baveno VI标准 (BC),扩展BC (EBC),AST-血小板比率指数,MELD-Na,肝硬度测量,FIB-4,CHESS-ALARM得分和EV和VNT的FIB-5得分的预测性能.
- 计算了ESOFAGOGASTRODOODENOSCOPY (EGD) 的避开率和EV和VNT的错过率.
主要成果:
- BC和EBC在识别患有EV,胃静脉 (GV) 和VNT的患者方面表现出准确性.
- 在48%的患者中,BC允许EGD节省,而EV的失误率为6.4%;在60%的患者中,EBC节省了EGD,而VNT的失误率为0%.
- BC,EBC,CHESS-ALARM得分和FIB-5得分独立预测了EV和VNT,在代谢功能障碍相关的脂肪性肝病 (MASLD) 和非MASLD组以及肥胖和非肥胖子组中表现相似.
结论:
- BC和EBC是节省cACLD患者EGD的宝贵工具,为EV,GV和VNT提供较低的失误率.
- 无论MASLD状态或肥胖,BC和EBC的表现都是一致的.
- CHESS-ALARM评分和FIB-5评分在预测CSPH (EV和VNT) 中具有高准确性.
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