Introduction: Many studies have shown that clinical, biochemical and ultrasonographic parameter are predictive of the presence and grading of esophageal varices. Aim of Study: Validation of a noninvasive test called P...Introduction: Many studies have shown that clinical, biochemical and ultrasonographic parameter are predictive of the presence and grading of esophageal varices. Aim of Study: Validation of a noninvasive test called P2/MS and its comparison with other noninvasive tests for the detection of high risk esophageal varices. Patients and Methods: We prospectively enrolled 125 consecutive patients with liver cirrhosis. Complete blood count [CBC], Platelet count by direct method, Liver functions [serum bilirubin, AST, ALT, prothrombin time and concentration and serum albumin], kidney functions, hepatitis markers for B & C, abdominal ultrasonography and upper gastrointestinal endoscopy were done for each patient. Calculation of P2/MS [Platelet count)<sup>2</sup>/{monocyte fraction (%) × segmented neutrophil fraction (%)], API [age-platelet index], APRI [AST-to-platelet ratio index], SPRI [spleen-to-platelet ratio index], ASPRI [age-spleen-to-platelet ratio index] scores and correlating the different scores with the grade of esophageal varices found on upper endoscopy. Results: During processing of our patient’s data, we found certain relation between segmented neutrophils, monocytes, platelet count, total bilirubin and the degree of esophageal varices for the detection of high risk varices and a new equation was formulated and we called it P2/MS-B. In predicting high risk esophageal varices HREV, the area under the curve for this new variable was [0.909, 95% confidence interval 0.858 - 0.961, p = 0.000] which was significantly higher than all the other variables including P2/MS for the detection of HREV. The sensitivity of the new equation for the detection of HREV is 85.3%, the specificity is 83.1%, the positive predictive value is 87.9%, the negative predicative value is 86.0 % and the overall accuracy of the test is 85.6%. Conclusion: A newly detected noninvasive variable for detecting HREV may reliably screen liver cirrhosis patients for HREV and avoid unnecessary endoscopy in low risk patients.展开更多
文摘目的探讨6周高原训练期间优秀男子赛艇运动员肱二头肌无创微循环相关指标变化特点。方法以10名国家赛艇队优秀男子赛艇运动员为研究对象,分别于高原训练前、高原训练期间、高原训练后3个阶段的每周休息日、晨空腹状态下,采用Peri Flux System 5000激光多普勒血流监测仪对10名运动员肱二头肌进行9次微循环相关指标测试,测试指标包括微循环血流灌注量(MBP)、运动血细胞浓度(CMBC)、运动血细胞平均速度(AVBC)等,测试值包括基础值与加热后值(44℃)。结果 6周高原训练期间运动员的MBP、CMBC和AVBC呈现波浪形变化特点,MBP和CMBC无论是基础值或是加热后值都在第3周上升至最高;AVBC基础值在第3周上升至最高,但第3周AVBC加热后值显著低于第2周和第4周(P<0.05)。结论高原训练中无创微循环指标呈现出波浪形的变化特点,MBP、CMBC变化特点主要与高原缺氧及运动负荷的变化有关,尤其是运动负荷的变化,而AVBC则主要与CMBC变化相关;下高原后MBP、CMBC储备能力大小对于运动员运动能力有着重要影响,其可作为检验高原训练是否达到效果的一种方法,且简便、无创。
文摘Introduction: Many studies have shown that clinical, biochemical and ultrasonographic parameter are predictive of the presence and grading of esophageal varices. Aim of Study: Validation of a noninvasive test called P2/MS and its comparison with other noninvasive tests for the detection of high risk esophageal varices. Patients and Methods: We prospectively enrolled 125 consecutive patients with liver cirrhosis. Complete blood count [CBC], Platelet count by direct method, Liver functions [serum bilirubin, AST, ALT, prothrombin time and concentration and serum albumin], kidney functions, hepatitis markers for B & C, abdominal ultrasonography and upper gastrointestinal endoscopy were done for each patient. Calculation of P2/MS [Platelet count)<sup>2</sup>/{monocyte fraction (%) × segmented neutrophil fraction (%)], API [age-platelet index], APRI [AST-to-platelet ratio index], SPRI [spleen-to-platelet ratio index], ASPRI [age-spleen-to-platelet ratio index] scores and correlating the different scores with the grade of esophageal varices found on upper endoscopy. Results: During processing of our patient’s data, we found certain relation between segmented neutrophils, monocytes, platelet count, total bilirubin and the degree of esophageal varices for the detection of high risk varices and a new equation was formulated and we called it P2/MS-B. In predicting high risk esophageal varices HREV, the area under the curve for this new variable was [0.909, 95% confidence interval 0.858 - 0.961, p = 0.000] which was significantly higher than all the other variables including P2/MS for the detection of HREV. The sensitivity of the new equation for the detection of HREV is 85.3%, the specificity is 83.1%, the positive predictive value is 87.9%, the negative predicative value is 86.0 % and the overall accuracy of the test is 85.6%. Conclusion: A newly detected noninvasive variable for detecting HREV may reliably screen liver cirrhosis patients for HREV and avoid unnecessary endoscopy in low risk patients.
