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目的探索晚期血吸虫病门脉高压所致胃底静脉曲张的无创性临床相关指标及分析其临床价值。方法收集120名晚期血吸虫病住院患者电子胃镜、腹部B超、外周血象、肝功能等临床指标,应用单因素及Logistic回归法分析腹部B超和外周血象等无创性指标与晚期血吸虫病门脉高压所致胃底静脉曲张的关系。结果单因素分析显示血红蛋白、红细胞、APTT、脾静脉内径、总蛋白、白蛋白、血钠以及肝功能分级与有无胃底静脉曲张存在显示出显著性意义(P<0.05),表明这些指标为胃底静脉曲张存在的无创性临床指标,经多因素Logistic回归分析显示总蛋白以及血钠最有临床价值,偏回归系数B分别为1.30、1.02(P=0.03、0.02),总蛋白与血钠的危险度比值exp(B)分别为3.68、2.76。结论总蛋白及血钠是预测晚期血吸虫病人胃底静脉曲张是否存在的最有意义的指标,可作为临床上诊断晚期血吸虫病胃底静脉曲张的临床诊断参考。
Objective To explore the noninvasive clinically relevant indexes of gastric varices induced by portal hypertension in advanced schistosomiasis and to analyze its clinical value. Methods The clinical data of 120 patients with advanced schistosomiasis were collected, including endoscopy, abdominal ultrasonography, peripheral blood and liver function. One-factor and Logistic regression analysis was used to analyze the noninvasive indices of abdominal ultrasonography and peripheral blood biopsy and advanced schistosomiasis portal hypertension Cause of gastric varices relationship. Results Univariate analysis showed that hemoglobin, erythrocyte, APTT, splenic vein diameter, total protein, albumin, serum sodium and liver function grading with or without gastric varices showed significant (P <0.05), indicating that these indicators were Non-invasive clinical indicators of gastric varices exist, the multivariate Logistic regression analysis showed that the total protein and serum sodium have the most clinical value, partial regression coefficient B were 1.30,1.02 (P = 0.03,0.02), total protein and serum sodium The risk ratio exp (B) were 3.68,2.76 respectively. Conclusion The total protein and serum sodium is the most significant index for predicting the presence of fundic varices in patients with advanced schistosomiasis. It may serve as a reference for the clinical diagnosis of advanced gastric schizo-varices.