The Predictive Value Of FibroScan And GPRI In The Degree Of Esophageal Varices In Patients With Hepatitis B Cirrhosis

Objective:To investigate the predictive value of FibroScan and gamma-glutamyl transpeptidase to platelet ratio index(GPRI)for the degree of esophageal varices in patients with hepatitis B cirrhosis,and analyze their advantages and disadvantages,to provide new ideas for noninvasive detection of esophageal varices.Methods:The general information of patients with hepatitis B cirrhosis who had been treated in the First Affiliated Hospital of Bengbu Medical College from November2017 to May 2019 has been collected,selected according to the inclusion and exclusion criteria,and the patients were classified according to《Tentative guidenlines for endoscopic diagnosis and treatment of varicosity and variceal bleeding in digestive tract(2009)》:no esophageal varices(G0),mild esophageal varices(GⅠ),moderate esophageal varices(GII),and severe esophageal varices(GIII).The measurement data after the normality test is expressed as mean±standard deviation(?x±s),the comparison between the groups is analyzed by one-way ANOVA,and the comparison between the groups of count data isχ~2-test.The ROC curve was drawn using the gastroscopy result as the gold standard.The two methods combined required Logistic regression to calculate the combined predictor before analysis,and compared the statistical indicators such as area,sensitivity,and specificity under the curve.Results:1.A total of 164 confirmed hepatitis B cirrhosis patients were included in the study,including 109 males and 55 females,with an average age(48.7?10.8)years.They were divided into four groups:group G0(51 cases),group GI(33 cases),group GII(36 cases)and group GIII(44 cases).2.Among 164 patients with hepatitis B cirrhosis:the average LSM(11.1?4.4)kPa and GPRI(0.27?0.14)in the G0 group;the average LSM(16.0?3.2)kPa and GPRI(0.48?0.16)in the GⅠgroup;The average LSM(20.5?6.9)kPa and GPRI(0.54?0.27)in the GⅡgroup;the average LSM(30.5?16.4)kPa and GPRI(0.77?0.45)in the GⅢgroup.With the increase of esophageal varices,LSM and GPRI values gradually increased.3.The arear under the ROC curve of LSM、GPRI、LSM+GPRI in patients with esophageal varices were0.891、0.874、0.931,mild esophageal varices were 0.845、0.858、0.910,moderate esophageal varices were 0.885、0.853、0.923,and severe esophageal varices were0.931、0.902、0.954.Conclusions:1.FibroScan and GPRI have a good predictive value for the degree of esophageal varices in patients with hepatitis B cirrhosis,and the combination of the two can significantly improve the diagnostic efficiency.2.Although the current non-invasive detection method cannot completely replace the gastroscope,it can be used as a supplement and alternative means of gastroscopy under limited resources.