关键词: 肝硬化, 凝血因子, 食管静脉曲张, 胃底静脉曲张

Abstract:

Objective To investigate noninvasive parameters or model for diagnosing esophageal and/or gastric fundus varices in patients with liver cirrhosis.
Methods Data of 58 patients with liver cirrhosis caused by hepatitis B were collected, 34 patients had esophageal and/or gastric varices. All patients were classified according to Child-Pugh grade(32 Child-Pugh-A, 13 Child-Pugh-B, 13 Child-Pugh-C). The laboratory Variables including coagulation factors and liver function tests were performed. Spleen thickness and portal vein width were measured on ultrasonography. Endoscopy was used to detect the esophageal and/or gastric fundus varices.
Results Patients with liver cirrhosis were divided into varices group and non-varices group, differences in platelet, prothrombin time activity(PTA), activated partial thromboplastin time，coagulation Factors Ⅱ, Ⅴ, Ⅶ, Ⅷ, Ⅸ, Ⅹ, fibrinogen, D-dimer，liver function factors(prealbumin, albumin, total bilirubin, total bile acid, cholinesterase), spleen thickness, and portal vein width between two groups were statistically significant(P<0.05). Through Logistic regression analysis, PTA, portal vein width, spleen thickness were the factors which help discriminating esophageal and/or gastric fundus varices existing or not in patients with liver cirrhosis, Logit P=12.280×portal vein width＋2.901×spleen thickness-0.145×PTA-17.746, predicting accuracy was 68.0%, sensitivity was 69.2%, specificity was 66.6%. Patients classified into ChildPugh A were also divided into varices group and nonvarices group, differences in PTA, D-dimer, coagulation factor Ⅱ, Ⅸ, platelet，spleen thickness, portal vein width between two group were statistically significant(P<0.05).
Conclusion PTA, portal vein width, and spleen thickness may help discriminate presence or absence of esophageal and/or gastric fundus varices in patients with liver cirrhosis.

Key words: liver cirrhosis, coagulation factors, esophageal varices, gastric fundus varices