Evaluation Of Fibroscan Combined With Ultrasound Portal Vein Pressure Measurement And Parameters Of Blood Predicting Esophageal Varices(EV) In Liver Cirrhosis

ObjectiveTo explore the correlation analysis of Transient elastography(Fibroscan)and other serological markers,ultrasonography in predicting portal pressure in cirrhosis,and to explore the value of Fibroscan,portal ultrasonography and parameters of blood in evaluating esophageal varices in cirrhosis.Method1.Collect 40 patients with cirrhosis diagnosed in outpatient and inpatient clinics of Affiliated Hospital of Yan’an University from December 2017 to February 2019.Exclude tumors and fail to cooperate with examinations.Collect general data and clinical manifestations of related patients.2.All the researchers were examined for blood routine,liver function,electrolyte and coagulation index at admission.Abdominal color Doppler ultrasonography and portal vein ultrasonography,Fibroscan,EGD were performed to detect the changes of portal vein blood flow and the degree of gastroesophageal varices in patients with liver cirrhosis.The patients were divided into two groups:esophageal varices group(EV group)and non-esophageal varices group(non-EV group).3.SPSS20.0 statistical software was used to analyze the results of the study.The measurement data conforming to normal distribution are expressed as mean±standard deviation(x±S).Comparing the normal distribution data of blood test,imaging results and EGD report,using t-test,multi-group data comparison and variance analysis,taking gastroscopy results as gold standard,drawing the working characteristic curves(ROC curves)of parameters of blood,portal vein ultrasonography,Fibroscan,portal vein ultrasonography combined with Fibroscan,and evaluating their diagnosis of EV.The difference was statistically significant(P<0.05).Result1.In this study,40 researchers were selected,8 researchers in non-EV group;32researchers in EV group,including 15 researchers in mild EV,7 researchers in moderate EV and 10 researchers in severe EV;18 males and 14 females in EV group,2 males and6 females in non-EV group.There was no significant difference in gender distribution between the two groups(P>0.05);the average age of EV group was(56±10.38)years,and the average age of non-EV group was(54±16.82)years.There was no significant difference in age distribution between the two groups(P>0.05).There were 40 patients with cirrhosis,33 with viral hepatitis and 7 with other causes,including 1 with Wilson’s disease,1 with alcoholism,1 with autoimmunity,and 4 with unknown etiology.There was no significant difference in the distribution of etiology between the two groups(P>0.05).2.There was no significant difference in PBF between EV group and non-EV group(P>0.05);SL was significantly different between the two groups,EV group as a whole was larger than non-EV group(P<0.05);and there was no significant difference in the PI between the two groups.There was significant difference in PPV between the two groups(P<0.05).3.LSM was significantly different between EV group and non-EV group(P<0.05),and the mean value of EV group was significantly higher than that of non-EV group.4.There was no significant difference in ALB,ALT,AST and Na~+between EV group and non-EV group(P>0.05).The ratio of APRI in EV group was significantly higher than that in non-EV group,the difference was statistically significant(P<0.05).There was no significant change in routine coagulation parameters PT and APTT between EV group and non-EV group(P>0.05).5.AUROC of PPV were 0.86(95%CL:0.70-1.00),cut-off value was 25.02mmHg,sensitivity 87.5%,specificity 87.5%;AUROC of LSM were 0.85(95%CL:0.71-0.98),cut-off value was 20.7kPa,sensitivity 81.3%,specificity 75%;when LSM and PPV were diagnosed jointly,AUROC reached 0.91(95%CL:0.83-1.00).The area under the ROC curve of APRI was 0.85(95%CL:0.71-0.98),the cut-off value was 1.09,the sensitivity was 90%,and the specificity was 75%.6.Pearson correlation analysis showed that there was a significant positive correlations between Na~+,APRI,LSM and PPV(r=0.43,r=0.61,r=0.57,P<0.05).Conclusion1.LSM is highly correlated with PPV,which may play an important role in noninvasive assessment of portal vein pressure.2.APRI,PI,PPV and LSM values can predict the occurrence of esophageal varices in patients with liver cirrhosis,of which PPV combined with LSM is the most valuable indicator for evaluation and follow-up.3.Routine biochemical indicators are affected by many factors,and are limited in judging whether esophageal varices occur in patients with liver cirrhosis.