Predictive Value Of ICGR15 Combined With Platelet And Hemoglobin In Liver Cirrhosis Complicated With Gastricesophageal Varices And Hemorrhage

Objective: to predict the occurrence of gastricesophageal varices(GEV)and bleeding in patients with liver cirrhosis by ICGR15 and other indicators.Methods: the clinical data of 123 patients with liver cirrhosis were analyzed retrospectively.the patients with liver cirrhosis were divided into two groups: non-GEV group 46 cases and GEV group 77 cases,GEV group was divided into bleeding group(n=20)and non-bleeding group(n=57)according to the presence or absence of upper gastrointestinal bleeding.Liver function,coagulation function,blood routine,the 15 minute retention rate of indocyanine green(Indocyanine green 15 minutes retention,ICGR15),hepatic effective blood flow(Effective hepatic blood flow,EHBF),and imaging data such as gastroscopy,abdominal CT were collected.Child-Turcotte-Pugh score(CTP score)was calculated at the same time.Results: 1.CTP classification,there were 16 cases of grade A,49 cases of grade B and60 cases of grade C.2.Univariate analysis: no GEV group compared with GEV group,Alanine aminotransferase(ALT),glutamylaminotransferase(r-GT),total bilirubin(TBi L),albumin(ALB),prothrombin time(PT),platelet(PLT),hemoglobin(Hb),CTP grading,The difference between ICGR15 and EHBF was statistically significant.Z values are.-2.19,-3.93,-4.43,-4.33,-4.97,-3.94,-3.92,-6.07,-0.62,-3.94,P<0.05;There were no significant differences in alkaline phosphatase(ALP),aspartate aminotransferase(AST),serum creatinine(SCr),white blood cell count(WBC)and aspartate aminotransferase / platelet ratio(APRI).3.Multivariate analysis: the scores of ALT,TBil,r-GT,PLT,Hb,PT,ICGR15,EHBF and CTP were introduced into Logistic regression analysis,and the three indexes of predicting GEV were obtained: ICGR15,PLT,Hb,p<0.05.the difference was statistically significant.Through the relationship among the three,the formula for predicting GEV is obtained as follows:Logit P=-0.635+0.089×ICGR15-0.015×PLT-0.279×Hb.4.Prediction of the value of GEV by various indexes The areas under the ROC curves of the prediction model and ICGR15,PLT and Hb were 0.924,0.833,0.285 and 0.287,respectively.when the truncation value of the prediction model was 0.406,the sensitivity and specificity were93.6% and 76.5%,respectively.5.Prediction of bleeding by ICGR15 and predictive model ICGR 15 value and predictive model value in bleeding group were higher than those in non-bleeding group.The areas under the ROC curve of ICGR15 and prediction model for predicting upper gastrointestinal bleeding were 0.705 and 0.787,respectively.When ICGR15>26.1%,the sensitivity and specificity of predicting upper gastrointestinal bleeding within one year were 76.6% and 63.8%,respectively.When the truncation value of the predictive model was 0.515,the sensitivity and specificity of predicting upper gastrointestinal bleeding within one year were 85.9% and 62.1%,respectively.Conclusion:ICGR15 combined with PLT and Hb can be used as a noninvasive p redictor of cirrhosis complicated with GEV and gastrointestinal bleeding.