摘要
目的探究新型炎症指数预测肝硬化门脉高压患者门静脉血栓形成的价值。方法本研究为单中心横断面研究,纳入2019年1月至2023年2月因肝硬化于上海市闵行区中心医院行门脉血管CT检查和肝静脉压力梯度(HVPG)测定明确合并门静脉高压的患者,根据是否合并门静脉血栓分为血栓组和无血栓组,并通过logistics回归分析和受试者工作特征(ROC)曲线判断单核细胞淋巴细胞比值(MLR)、中性粒细胞淋巴细胞比值(NLR)、血小板淋巴细胞比值(PLR)和全身免疫炎症指数(SII)对门静脉血栓的预测价值。结果最终纳入122例患者,根据门脉血管CT结果分为血栓组20例,无血栓组102例。血栓组患者MLR和PLR显著高于无血栓组患者(P=0.0387,P=0.0407)。两组血红蛋白、血小板、白细胞、中性粒细胞、淋巴细胞、单核细胞、NLR、SII、白蛋白、ALT、总胆红素、肌酐、凝血酶原时间、D-二聚体、C反应蛋白比较差异均无统计学意义(均P>0.05)。通过logistics回归模型构建门脉血栓诊断模型,发现MLR联合D-二聚体和腹水的ROC曲线下面积为0.900,灵敏度为0.850,特异度为0.431。结论新型炎症指数(包括MLR和PLR)在门静脉血栓形成的肝硬化患者中显著升高,MLR联合D-二聚体、腹水可以预测肝硬化门静脉血栓形成。
Objective To explore the value of a new inflammatory index in predicting portal vein thrombosis in cirrhotic patients with Portal hypertension.Methods This study was a single center cross-sectional study.The patients with portal hypertension who underwent portal vein computed tomography(CT)examination and hepatic vein pressure gradient(HVPG)measurement in the Minhang District Central Hospital of Shanghai from January 2019 to February 2023 due to cirrhosis were included.They were divided into thrombosis group and non thrombosis group according to whether portal vein thrombosis was combined or not.The predictive value of Monocyte lymphocyte ratio(MLR),neutrophil lymphocyte ratio(NLR),platelet lymphocyte ratio(PLR)and systemic immune inflammatory index(SII)for portal vein thrombosis was determined by logistic regression analysis and receiver operating characteristic(ROC)curve.Results A total of 122 patients were ultimately included and were divided into a thrombus group of 20 and a non thrombus group of 102 based on portal vein CT results.The MLR and PLR of patients in the thrombotic group were significantly higher than those in the non thrombotic group(P=0.0387,P=0.0407).There was no significant difference in hemoglobin,platelets,leukocytes,neutrophils,lymphocytes,monocyte,NLR,SII,albumin,alanine aminotransferase(ALT),total bilirubin,creatinine,prothrombin time,D-dimer,and C-reactive protein between the two groups(all P>0.05).The diagnosis model of portal vein thrombosis was constructed by logistic regression model.It was found that the area under the ROC of MLR combined with D-dimer and ascites was 0.900,the sensitivity was 0.850,and the specificity was 0.431.Conclusions The new inflammatory index(including MLR and PLR)is significantly increased in cirrhotic patients with portal vein thrombosis.MLR combined with D-dimer and ascites can predict portal vein thrombosis in cirrhotic patients.
作者
李煜
陈颖
方青青
陈炜
Li Yu;Chen Ying;Fang Qingqing;Chen Wei(Department of Gastroenterology,the Minhang Hospital(the Minhang District Central Hospital)Affiliated to the Fudan University,Shanghai 201199,China)
出处
《中国医师杂志》
CAS
2023年第6期805-808,共4页
Journal of Chinese Physician
基金
上海市卫生健康委先进适宜技术推广项目(2019SY028)。
关键词
肝硬化
高血压
门静脉
静脉血栓形成
炎症指数
Liver cirrhosis
Hypertension,portal
Venous thrombosis
Inflammation indices
