| Objective: By comparing the differences of serum IL-6,VEGF,PLT,and portal vein width between the liver cirrhosis esophageal varices hemorrhage group and the non-hemorrhagic group,and the differences between groups of different degrees of cirrhosis and esophageal varices,to explore the serum IL-6,Clinical significance of VEGF,PLT and portal vein width in esophageal varices in liver cirrhosis.Methods: This study collected a total of 102 patients with liver cirrhosis who were admitted to the Department of Gastroenterology,Yan’an University Affiliated Hospital from September 2020 to February 2022,with an age range of 24-81 years.（1）Divided into EVB group（64 cases）and NEVB group（38 cases）according to whether complicated with esophageal venous rupture and bleeding;（2）According to the results of gastroscopy,they were divided into NEV group（13 cases）and EV group（89 cases）,The patients in the esophageal varices group were divided into mild-moderate EV group（37cases）and severe EV group（52 cases）according to the grade of esophageal varices.All patients included in the study reviewed their cases,collected general information（age,gender,BMI,smoking history,drinking history,etc.）and recorded them in the EXCEL form.After admission,venous blood was collected for vascular endothelial growth factor（VEGF）,interleukin-6（IL-6）,platelet count（PLT）and other tests,and the parameter results were collected.Gastroscopy,portal vein width and other indicators were collected.Comparative analysis: 1.Comparison of general data and laboratory indexes between EVB group and NEVB group,EV group and NEV group;2.Comparison of laboratory indexes between different EV severity in EV group;3.Serum IL-6,VEGF,PLT,Correlation analysis between portal vein width and EV severity;4.Draw serum IL-6,VEGF,PLT,portal vein width and the ROC curves of combined indicators to predict EVB and severe EV respectively,calculate IL-6,VEGF,PLT,portal vein width and The area under the curve,positive predictive value,and negative predictive value of the combined indicators were used to evaluate the diagnostic performance.Results:1.Univariate analysis was performed on the EVB group and non-EVB group with cirrhosis and esophageal varices.After the normality test,the data that conformed to the normal distribution were included in the t test,and the data that did not conform to the normal distribution were included in the Mann-Whitney Statistical analysis was performed by U test,respectively.VEGF（P=0.000）,IL-6（P=0.000）,portal vein width（P=0.000）,and PT（P=0.003）were significantly increased in the hemorrhage group,while PLT（P=0.003）was significantly increased in the hemorrhage group.0.002),RBC（P=0.002）,HB（P=0.001）,TP（P=0.007）,AST（P=0.003）,GGT（P=0.003）were significantly lower in the bleeding group.There was no significant difference in ALB,ALT,TBIL,APTT and TT between the two groups（P>0.05）.2.Univariate analysis was carried out in the two groups of mild-moderate EV and severe EV.After the normality test,the data that conformed to the normal distribution were included in the t test,and the data that did not conform to the normal distribution were included in the Mann-Whitney U test.Statistical analysis showed that VEGF（P=0.000）,IL-6（P=0.000）,and portal vein width（P=0.004）in the mild-moderate EV group were significantly lower than those in the severe EV group.There was no significant difference in PLT and other indicators between the two groups（P>0.05）.3.The correlation analysis between the different degrees of esophageal varices and the levels of serum VEGF,IL-6,PLT and portal vein width showed that: VEGF,IL-6,portal vein width were positively correlated with the severity of esophageal varices（the correlation coefficients were 0.388,0.638,0.309）,PLT was negatively correlated with the severity of esophageal varices,the correlation coefficient was-0.286,and the differences were statistically significant（all P<0.05）.4.ROC curve was drawn with the results of gastroscope as reference,and the predictive value of serum IL-6,VEGF,PLT,and portal vein width on EVB was evaluated.The areas under the ROC curve are: 0.822,0.787,0.315,0.690,0.840,respectively.The optimal cut-off values of serum IL-6,VEGF,PLT,and portal vein width were 7.58 pg/ml,94.20 pg/ml,80.00*10^9/L,and 12.5 mm,respectively;VEGF and IL-6 in the severe EV group under gastroscope were drawn.The ROC curves of IL-6,VEGF,portal vein width,and the three combined indexes were used to evaluate the predictive value of serum IL-6,VEGF,and portal vein width on severe EV.The areas under the ROC curve were: 0.814,0.752,0.684,and 0.838,respectively.The optimal cutoff values of serum IL-6,serum VEGF and portal vein width were 10.10 pg/ml,100.63 pg/ml and 13.50 mm,respectively.Conclusion: 1.The values of VEGF,IL-6 and portal vein width were significantly increased in patients with liver cirrhosis and EV,while the PLT value was significantly decreased in patients with liver cirrhosis and EV.2.VEGF,IL-6,PLT,and portal vein width can be used as predictors of EVB and are closely related to the degree of EV in liver cirrhosis. |
