血小板、白蛋白/球蛋白比值和门静脉内径在肝硬化食管胃底静脉曲张中的诊断价值研究

Study on the Diagnostic Value of Platelets, Albumin/Globulin Ratio, and Portal Vein Diameter in Esophageal and Gastric Varices in Liver Cirrhosis

摘要: 目的：探讨血小板(PLT)、白蛋白/球蛋白比值(A/G)和门静脉内径对肝硬化患者发生食管胃底静脉曲张(EGV)的预测价值。方法：选取2021年1月~2025年11月在常德市第二人民医院收治的肝硬化患者并行电子胃镜、肝胆脾胰 + 门静脉系彩超37例，按电子胃镜检查结果分为EGV组22例和无EGV组15例。采用Logistic回归分析肝硬化食管胃底静脉曲张的危险因素，利用ROC曲线分析血小板、白蛋白/球蛋白比值和门静脉内径在肝硬化食管胃静脉曲张中的诊断价值。计算曲线下面积(AUC)及其截断值以及相应敏感性、特异性。结果：一般资料显示：在有静脉曲张组中，ALB、A/G、HB值均低于无静脉曲张组，差异有统计学意义(P < 0.05)；单因素二元Logistic回归分析中可以得出，EGV组与无EGV组的ALB、门静脉内径、HB、A/G与静脉曲张有统计学差异，P < 0.05。二元Logistic回归分析结果可知，门静脉内径是肝硬化食管胃底静脉曲张的危险因素，门静脉内径的曲线下面积(AUC)为0.800，95%置信区间为(0.645, 0.955)，预测肝硬化食管胃底静脉曲张的最佳门静脉内径临界值为11.5 mm，敏感度为86.4%，特异性为33.3%。AUC有差异(P < 0.05)；门静脉内径值对肝硬化食管胃底静脉曲张具有预测价值。

Abstract: Objective: To explore the predictive value of platelet count (PLT), albumin/globulin ratio (A/G), and portal vein diameter for esophagogastric varices (EGV) in patients with liver cirrhosis. Methods: A total of 37 patients with liver cirrhosis who were admitted to the Second People’s Hospital of Changde from January 2021 to November 2025 and underwent electronic gastroscopy and color Doppler ultrasound of the liver, gallbladder, spleen, pancreas, and portal vein system were selected. They were divided into the EGV group (22 cases) and the non-EGV group (15 cases) based on the results of electronic gastroscopy. Logistic regression analysis was used to identify the risk factors for esophagogastric varices in liver cirrhosis, and the diagnostic value of platelet count, albumin/globulin ratio, and portal vein diameter in esophagogastric varices of liver cirrhosis was analyzed using the ROC curve. The area under the curve (AUC), its cut-off value, and the corresponding sensitivity and specificity were calculated. Results: General data showed that in the varices group, the values of ALB, A/G, and HB were lower than those in the non-varices group, and the differences were statistically significant (P < 0.05). Univariate binary logistic regression analysis indicated that there were statistically significant differences in ALB, portal vein diameter, HB, and A/G between the EGV group and the non-EGV group (P < 0.05). Binary logistic regression analysis results showed that portal vein diameter was a risk factor for esophagogastric varices in liver cirrhosis. The AUC of portal vein diameter was 0.800, with a 95% confidence interval of (0.645, 0.955). The optimal cut-off value of portal vein diameter for predicting esophagogastric varices in liver cirrhosis was 11.5 mm, with a sensitivity of 86.4% and a specificity of 33.3%. The AUC was significantly different (P < 0.05). The portal vein diameter value has predictive value for esophagogastric varices in liver cirrhosis.