Prediction for Improvement of Liver Function after Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices to Manage Portosystemic Shunt Syndrome
Prediction for Improvement of Liver Function after Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices to Manage Portosystemic Shunt Syndrome
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DOI：
10.1016/j.jvir.2016.03.031
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发表时间：
2016-08-01
影响因子：
2.9
通讯作者：
Miki, Yukio
中科院分区：
文献类型：
--
作者：
Yamamoto, Akira;Nishida, Norifumi;Miki, Yukio
目的：探讨胃静脉曲张（GV）球囊闭塞逆行经静脉闭塞术（BRTO）后肝功能改善的预测因素和瞬时弹性成像（TE）测量的截止值。材料与方法：回顾性分析2011年1月至2015年2月BRTO前接受TE治疗的50例BRTO术后连续随访10 ~ 3个月的患者。肝功能（总胆红素、白蛋白和凝血酶原时间）变化与TE基线肝功能值和肝硬度测量（LSM）的相关性采用Pearson相关检验。使用受试者工作特征曲线来确定区分肝功能改善患者和未改善患者的临界值。从BRTO到食管静脉曲张（EV）恶化（形态恶化、新静脉曲张发展或静脉曲张破裂）的时间间隔也按截断值分组进行了分析。结果：BRTO术后3个月血清白蛋白明显改善（3.57 g/dL vs 3.74 g/dL, P < 0.001）。白蛋白变化与基线LSM呈显著负相关（r = 0.50, P < 0.001）。LSM的最佳截断点是
Purpose: To investigate predictive factors and cutoff value of transient elastography (TE) measurements for assessing improvement in liver function after balloon-occluded retrograde transvenous obliteration (BRTO) for gastric varices (GV).Materials and Methods: Retrospective analysis was performed of 50 consecutive patients followed for > 3 months after BRTO, who had undergone TE before BRTO between January 2011 and February 2015. The correlation between change in liver function (total bilirubin, albumin, and prothrombin time) and baseline liver function values and liver stiffness measurement (LSM) by TE was evaluated by Pearson correlation test. Receiver operating characteristic curves were used to determine cutoff values for discriminating between patients who had improved liver function and patients who did not. The time interval from BRTO to aggravation of esophageal varices (EV) (worsening morphology, development of new varices, or variceal rupture) grouped by cutoff values was also analyzed.Results: Serum albumin was significantly improved at 3 months after BRTO (3.57 g/dL vs 3.74 g/dL, P < .001). There was a significant negative correlation between change in albumin and baseline LSM (r = 0.50, P < .001). The best cutoff point for LSM was