Non-invasive predictors of the presence of large oesophageal varices in patients with cirrhosis
Non-invasive predictors of the presence of large oesophageal varices in patients with cirrhosis
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DOI：
10.1016/s1590-8658(03)00219-6
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发表时间：
2003-07-01
影响因子：
4.5
通讯作者：
Nikolopoulou, V
中科院分区：
文献类型：
--
作者：
Thomopoulos, KC;Labropoulou-Karatza, C;Nikolopoulou, V
背景/目标。通常的临床实践是通过上消化道内窥镜对所有确诊肝硬化的患者进行静脉曲张的筛查，静脉曲张较大的患者应使用非选择性β受体阻滞剂治疗，以减少首次静脉曲张出血的发生率。然而，少于50%的胃底静脉曲张患者在筛选内镜检查时有静脉曲张，大多数静脉曲张较小。出血风险低本研究的目的是确定临床或实验室非内窥镜参数是否可以预测大食管静脉曲张的存在。患者/方法在184例接受内镜筛查的肝硬化患者中检测了17个被认为与食管静脉曲张患病率相关的变量。小静脉曲张被认为是那些随着注气而变平或稍微突出到管腔中的静脉曲张。而大的静脉曲张是突出到管腔中或彼此接触的静脉曲张。所有患者均未使用β受体阻滞剂或其他血管活性药物，也无静脉曲张出血史。食管静脉曲张92例（50%），大静脉曲张33例（17.9%）。单因素分析显示，与食管静脉曲张相关的变量是临床检查或超声检查发现的腹水和脾肿大（p
Background/Aims. The usual clinical practice is to screen all patients with established cirrhosis at the time of diagnosis by upper endoscopy for the presence of varices.Patients with large varices should be treated with non-selective beta blockers to reduce the incidence of first variceal bleeding. However, fewer than 50% of cirrhotic patients have varices at screening endoscopy and most have small sized varices. with a low risk of bleeding. The aim of the present study was to determine whether clinical or laboratory non-endoscopic parameters could predict the presence of large oesophageal varices. Patients/Methods. Seventeen variables considered relevant to the prevalence of oesophageal varices were tested in 184 patients with cirrhosis, who underwent screening endoscopy. Small varices were regarded as those which flatten with insufflation or slightly protrude into the lumen. while large varices are those which protrude into the lumen or touch each other. None of the patients was on beta blockers or other vasoactive drugs or had a history of variceal bleeding.Results. Oesophageal varices were present in 92 patients (50%), and large varices in 33 patients (17.9%). Variables associated with the presence of large oesophageal varices on univariate analysis were the presence of ascites and splenomegaly either by clinical examination or by ultrasound (p