Clinical Study Of Fibroscan In Predicting Alcoholic Liver Disease Complicated With Esophagogastric Varices Bleeding

Background In recent years,the incidence and mortality of Alcoholic Liver Disease(ALD)have been on the rise globally.In advanced ALD patients,esophagogastric variceal bleeding is the most common,and the risk of rebleeding is extremely high,with high mortality and poor prognosis.Therefore,early detection of the degree of liver disease in patients and prevention of esophagogastric variceal bleeding are of great significance to reduce the case fatality rate and reduce the family burden.Objective Explore instantaneous elastic imaging(Fibro Scan)of ALD patients with Liver Stiffness Measure(Liver Stiffness Measure,LSM)value to predict the diagnostic value of ruptured esophagogastric variceal bleeding.Methods 1.Participants: A continuous cross-sectional study was conducted on 93 patients with alcoholic liver disease who were treated in Luoyang Central Hospital Affiliated to Zhengzhou University from April 2018 to April 2019.2.Research methods: grouped according to the degree of esophagogastric varices and the number of bleeding ruptures of esophagogastric varices.Fibro Scan was used to detect liver stiffness value,Controlled Attenuation Paramter(CAP),blood routine,liver function,coagulation function,Alpha Fetoprotein(AFP),abdominal color Doppler ultrasound and gastroscopy(Esophageal and gastroscopy)in patients with alcoholic liver disease Gastric Endoscopy(EGD).3.Statistical method: SPSS 22.0 statistical software is used,measurement data is expressed as mean ± standard deviation,t test is used for comparison of two sets of quantitative data,normality and variance homogeneity test are used for comparison of multiple sets of quantitative data,and single factor variance is used for variance.Analysis,uneven variance using non-parametric Kruskal-Wallis test,P <0.05 was considered statistically significant.Draw Receiver Operating Characteristic Curve(ROC),and evaluate the accuracy of diagnosis according to Area Under the Receiver Operating Characteristic Curve(AUROC).Results 1.The levels of CAP,Red blood Cell Count(RBC),Hemoglobin(HB),blood Platelet Count(PLT)and Albumin(ALB)in the group without gastroesophageal varices veins were significantly higher than those of the group gastroesophageal varices veins.The levels of LSM value,Total Bilirubin(TBIL),Prothrombin Time(PT),International Normalized Ratio(INR),Activated Partial Thromboplastin Time(APTT),Thrombin Time(TT),portal vein width,spleen thickness and splenic vein width in the group of gastroesophageal varices veins were significantly higher than those of the group without gastroesophageal varices(P < 0.05).2.With the aggravation of gastroesophageal varices,patients’ LSM value,TBIL,portal vein width,spleen thickness and splenic vein width also gradually increased,while HB and PLT gradually decreased(P < 0.05).There were significant differences between the severe gastroesophageal varices vein group and the moderate,mild and non-gastroesophageal varices vein group(P < 0.05).3.With the increase of bleeding times,the patient’s LSM value,diameter of the coarsest gastroesophageal varices,portal vein width and spleen thickness also gradually increased;There were significant differences between the multiple bleeding group,the single bleeding group and the non-bleeding group(P < 0.05).4.The optimal LSM threshold value,sensitivity,specificity and AUROC were 18.25 kpa,85.7%,71.4% and 0.837 respectively in the ALD group without rupture and hemorrhage of gastroesophageal varices.The optimal LSM threshold value,sensitivity,specificity and AUROC of the single bleeding group were 31.5kpa,75.0% and 70.0%,respectively.The optimal LSM threshold value,sensitivity,specificity and AUROC were 40.7kpa,92.3%,66.7% and 0.923,respectively.Conclusion Using Fibro Scan to detect the LSM value of ALD patients has a good predictive value for esophagogastric varices bleeding.