预测慢性肝病患者胃食管静脉曲张和静脉曲张破裂出血的新

StephenW

Ann Hepatol. 2020 Feb 11. pii: S1665-2681(20)30005-3. doi: 10.1016/j.aohep.2019.12.007. [Epub ahead of print]
New model predicting gastroesophageal varices and variceal hemorrhage in patients with chronic liver disease.
Ma JL1, He LL1, Jiang Y1, Yang JR1, Li P1, Zang Y2, Wei HS3.
Author information

1
    Capital Medical University Affiliated Beijing Ditan Hospital, Department of Gastroenterology, Beijing, China.
2
    Capital Medical University Affiliated Beijing Ditan Hospital, Department of Medical Ultrasound, Beijing, China.
3
    Department of Gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing, China. Electronic address: [email protected].

Abstract
INTRODUCTION AND OBJECTIVES:

The predictors for gastroesophageal varices (GOV) and hemorrhage development have not been well studied in different liver diseases or different population. This study aimed to evaluate whether a new algorithm focusing on chronic hepatitis B (CHB) patients is also applicable to other chronic liver diseases (CLDs) in Chinese population.
PATIENTS OR MATERIALS AND METHODS:

We retrospectively analyzed 659 CHB patients and 386 patients with other CLDs. A total of 439 CHB patients were included in training set, the other 220 CHB patients and other patients with CLDs were included in validation set. A new algorithm for diagnosing GOV was established and its sensitivity and specificity for predicting the varices was verified.
RESULTS:

Multivariable logistic regression revealed that the rough surface of the liver (p<0.001), splenic thickness (p<0.001), and liver stiffness (p=0.006) were independent predictors of GOV. The new algorithm was considered to be a reliable diagnostic model to evaluate the presence of varices. The AUROC was 0.94 (p<0.001) in CHB validation set and 0.90 (<0.001) in non-CHB validation set. When the cut-off value was chosen as -1.048, the sensitivity and specificity in diagnosing GOV in CHB population were 89.1% and 82.5%, respectively. Importantly, the new algorithm accurately predicted the variceal hemorrhage not only in CHB patients, but also in patients with other CLDs.
CONCLUSION:

The new algorithm is regarded as a reliable model to prognosticate varices and variceal hemorrhage, and stratified not only the high-risk CHB patients, but also in patients with other CLDs for developing GOV and variceal bleeding.

Copyright © 2020 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.
KEYWORDS:

Algorithm; Chronic hepatitis B; Gastroesophageal varices; Variceal hemorrhage

PMID:
    32197976
DOI:
    10.1016/j.aohep.2019.12.007

StephenW

安·赫帕托尔。 2020年2月11日。pii：S1665-2681（20）30005-3。 doi：10.1016 / j.aohep.2019.12.007。 [Epub提前发行]
预测慢性肝病患者胃食管静脉曲张和静脉曲张破裂出血的新模型。
马JL1，何LL1，江Y1，杨JR1，李P1，Z Y2，卫HS3。
作者信息

1个
    首都医科大学附属北京地坛医院消化内科，北京
2
    首都医科大学附属北京地坛医院，超声医学科，北京
3
    首都医科大学附属北京地坛医院消化内科，北京电子地址：[email protected]。

抽象
简介和目标：

在不同的肝脏疾病或不同人群中，胃食管静脉曲张（GOV）和出血发展的预测因素尚未得到很好的研究。这项研究旨在评估针对慢性乙型肝炎（CHB）患者的新算法是否也适用于中国人群中的其他慢性肝病（CLD）。
患者或材料与方法：

我们回顾性分析了659名CHB患者和386名其他CLD患者。总共439名CHB患者被纳入训练组，其他220名CHB患者和其他CLD患者被纳入验证组。建立了一种新的GOV诊断方法，并验证了其对静脉曲张的敏感性和特异性。
结果：

多变量logistic回归显示，肝脏的粗糙表面（p <0.001），脾脏厚度（p <0.001）和肝硬度（p = 0.006）是GOV的独立预测因子。新算法被认为是评估静脉曲张存在的可靠诊断模型。 CHB验证集中的AUROC为0.94（p <0.001），非CHB验证集中的AUROC为0.90（<0.001）。当临界值选择为-1.048时，CHB人群诊断GOV的敏感性和特异性分别为89.1％和82.5％。重要的是，新算法不仅可以准确预测CHB患者的静脉曲张出血，还可以准确预测其他CLD患者的静脉曲张出血。
结论：

新算法被认为是预测静脉曲张和静脉曲张破裂出血的可靠模型，并且不仅对高危CHB患者进行分层，而且对患有其他CLD的GOV和静脉曲张破裂出血患者进行分层。

版权所有©2020FundaciónClínicaMédicaSur，A.C.由ElsevierEspaña，S.L.U发布。版权所有。
关键字：

算法;慢性乙型肝炎；胃食管静脉曲张；静脉曲张出血

PMID：
    32197976
DOI：
    10.1016 / j.aohep.2019.12.007

StephenW

https://www.sciencedirect.com/sc ... 20300053?via%3Dihub