【摘要】 目的:探讨血小板计数/脾径比值无创性预测肝硬化并食管静脉曲张的临床价值。方法:326例肝硬化患者入院时均行血生化、腹部超声及胃镜检查。血小板计数取患者住院期间3次平均值,B超测量脾脏最长径,并计算血小板计数/脾径比值。将326例肝硬化患者根据胃镜检查结果分为2组:有食管静脉曲张组136例和无食管静脉曲张组190例。并将相关数据进行统计分析。根据血小板计数/脾径比值的平均数和标准差来确定判断有、无食管静脉曲张的临界值,根据临界值预测有、无食管静脉曲张的存在,并与金标准比较,得出其真假阳性和真假阴性例数,并计算其敏感性、特异性、阳性预测值和阴性预测值。结果:326例患者中,临界值0.42时,敏感性、特异性、阳性预测值、阴性预测值分别为90%、96%、94%、92%;相关性分析结果显示,血小板计数与有、无食管静脉曲张呈无相关(r=0.1640、0.1328,P均>0.05),脾径与有食管静脉曲张呈正相关(r=0.2111,P<0.05),血小板计数/脾径与有食管静脉曲张呈正相关(r=0.2351,P<0.01)。结论:血小板计数/脾径比值可有效判断有、无食管静脉曲张的存在,是一个良好的无创预测指标。更多还原

【Abstract】 Objective: To evaluate the clinical value of the platelet count/spleen diameter ratio in detecting the presence of esophageal varices(EV).Methods:Three hundred and twenty six liver cirrhotic patients were enrolled,and they all underwent biochemistry,abdominal ultrosonographic examination and endoscopy at the same time.Platelet count adopted the thrice mean numerical value when the patients were in hospital.B ultrosonographic examination measured spleen first born diameter.Then we calculated the platelet count/spleen diameter ratio.We divided the 326 liver cirrhosis patients according endoscopic result into two groups:136 patients with EV and 190 without EV.We compared statistically correlative data.We estimated critical values of esophageal varices according to the platelet count/spleen diameter ratio’s equal count and standard deviation,then calculated its sensitivity,specificity,positive and negative predictive value respectively by comparing the critical values with gold guard.Results:When the critical value was 0.42 in the 326 patients,the sensitivity,specificity,positive and negative predictive value was 90%,96%,94%,and 92% respectively;The results of correlated analysis had showed:there was no association between platelet count and esophageal varices(r=0.1640、0.1328,respectively,P>0.05,all);the spleen diameter was associated with the presence of esophageal varices(r=0.2111,P<0.05)and the platelet count/spleen diameter ratio was significantly associated with the presence of esophageal varices(r=0.2351,P<0.01).Conclusion:The platelet count/spleen diameter ratio could predict effectively the presence of esophageal varices,and it is a good non-invasive tool.更多还原