The aim of this study was to identify possible clinical, biochemical or instrumental markers which can predict in a non-invasive manner the presence of EV. One hundred and fifty-eight consecutive liver cirrhotic patients seen at our outpatient clinic were included in this study. The diagnosis of LC was done on liver biopsy findings or based on instru m e n t a l , clinical and serological data. Patients underwent EGE, ultra - sound of the upper abdomen, Doppler of the main splancnic vessels and the main parameters of liver function were tested. Liver cirrhosis was mostly correlated to hepatitis C virus and most patients were class A according to Child. At EGE, EV w e re absent in 41 patients, grade 1 in 86 patients, while 22 and 9 patients presented varices grade 2 and 3, re s p e c t i v e l y. When patients were divided according to the presence/absence of varices, statistically significant differences re g a rding pro t h rombin activity values (p<0.002), platelet (p<0.0001) and WBC count (p<0.002), portal vein dimensions (p<0.003), albumin levels (p<0.02), n° of platelet/spleen dia - meter ratio (p<0.0001) and n° of WBC/spleen diameter ratio (p<0.0001), were found. Multiple logistic regression of parameters significant at univariate analysis showed a statistically significant associa - tion with the presence of varices only for number of platelet/longitudinal spleen diameter ratio (p<0.0001) and for prothrombin activity values (p<0.03). When patients were divided into two groups, without and with varices grade 1, and with varices grade 2 and 3, several parameters resulted significant at univariate analysis, but among these, at multivariate analysis, only the platelet count and platelet count/spleen diameter ratio were confirmed to be associated to diagnosis of severe EV, p<0.03 and p<0.001, respectively. In conclusion our data agree with those of the literature about the absence of reliable non invasive predictors of EV in c i rrhotic patients, being platelet count and platelet count/spleen diameter ratio the best one, but not yet sufficient to avoid a lot of useless EGE in cirrhotic patients.
PARRINO A, DI GESARO V, TERRANOVA A, SESTI R, CORSALE S, PATTI AM, et al. (2008). Diagnostica non invasiva delle varici esofagee nei pazienti con cirrosi epatica: dati ecografici vs dati endoscopici. ACTA MEDICA MEDITERRANEA, 24 (1), 11-17.
Diagnostica non invasiva delle varici esofagee nei pazienti con cirrosi epatica: dati ecografici vs dati endoscopici
PARRINO, Alessandro;DI GESARO, Valeria;SESTI, Roberta;PATTI, Angelo Maria;SORESI, Maurizio
2008-01-01
Abstract
The aim of this study was to identify possible clinical, biochemical or instrumental markers which can predict in a non-invasive manner the presence of EV. One hundred and fifty-eight consecutive liver cirrhotic patients seen at our outpatient clinic were included in this study. The diagnosis of LC was done on liver biopsy findings or based on instru m e n t a l , clinical and serological data. Patients underwent EGE, ultra - sound of the upper abdomen, Doppler of the main splancnic vessels and the main parameters of liver function were tested. Liver cirrhosis was mostly correlated to hepatitis C virus and most patients were class A according to Child. At EGE, EV w e re absent in 41 patients, grade 1 in 86 patients, while 22 and 9 patients presented varices grade 2 and 3, re s p e c t i v e l y. When patients were divided according to the presence/absence of varices, statistically significant differences re g a rding pro t h rombin activity values (p<0.002), platelet (p<0.0001) and WBC count (p<0.002), portal vein dimensions (p<0.003), albumin levels (p<0.02), n° of platelet/spleen dia - meter ratio (p<0.0001) and n° of WBC/spleen diameter ratio (p<0.0001), were found. Multiple logistic regression of parameters significant at univariate analysis showed a statistically significant associa - tion with the presence of varices only for number of platelet/longitudinal spleen diameter ratio (p<0.0001) and for prothrombin activity values (p<0.03). When patients were divided into two groups, without and with varices grade 1, and with varices grade 2 and 3, several parameters resulted significant at univariate analysis, but among these, at multivariate analysis, only the platelet count and platelet count/spleen diameter ratio were confirmed to be associated to diagnosis of severe EV, p<0.03 and p<0.001, respectively. In conclusion our data agree with those of the literature about the absence of reliable non invasive predictors of EV in c i rrhotic patients, being platelet count and platelet count/spleen diameter ratio the best one, but not yet sufficient to avoid a lot of useless EGE in cirrhotic patients.File | Dimensione | Formato | |
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