| Objective To investigate the correlation between non-invasive serological model RPR(red blood cell volume distribution width to platelet ratio),GPR(γ-glutamyl transpeptidase to platelet ratio),APRI(aspartate aminotransferase to platelet ratio)and FIB-4(fibrosis 4 score),respectively,and the Child classification of patients with hepatitis B liver cirrhosis,and the predictive value of these models for hepatitis B liver cirrhosis esophagogastric variceal bleeding(EVB).Methods One hundred and thirty four patients with hepatitis B liver cirrhosis who were hospitalized in the Central Hospital of Tujia and Miao Autonomous Prefecture in Enshi Prefecture from January 2017 to October 2020 were selected as the case group,and the clinical data of this admission was collected.One hundred and thirty four cases of hepatitis B liver cirrhosis were divided into group Child A,Child B,and Child C according to the Child classification standard.Forty healthy people of the same age group were randomly selected from our hospital as the control group.This study recorded the values of RDW,GGT,PLT,AST and ALT of case and control groups and calculated the RPR,GPR,APRI,FIB-4 of the case group and the control group.The correlation between the above model and Child classification was analyzed by Spearman linear correlation analysis.From the case group,ninety three patients who have completed the gastroscopy examinatioin were selected and divided into bleeding group and non-bleeding group according to the diagnostic criteria of EVB.This study compared the general clinical data between the two groups of patients and further conducted the binary multivariate logistic regression of the indicators in the univariate analysis with statistically significance to obtain predictors of EVB.The area under the receiver operating characteristic curve(ROC)was used to assess the predictive value of the above model for EVB.Results 1.According to Child classification,the one hundred and thirty four patients with hepatitis B liver cirrhosis were grouped into Child A,Child B and Child C.The result is as follows: among control group,Child A,Child B and Child C,the RPR value was not statistically different between Child B and Child C groups(P=0.08),and there were statistical differences between the other groups(P<0.05);The GPR,APRI,and FIB-4 values were statistically different in pairwise comparison between each group(P<0.05).The values of RPR,GPR,APRI and FIB-4 increased with the increase of Child grade.2.According to Spearman linear correlation analysis,the RPR,GPR,APRI and FIB-4 were positively correlated with Child classification.3.Ninety three patients who have completed the gastroscopy examination were divided into non-bleeding group and bleeding group.The RPR,GPR,APRI and FIB-4 were statistically significant in comparison between the non-bleeding group and the bleeding group(P<0.05).4.Two-class multivariate logistic regression analysis indicated that RPR,GPR and FIB-4 were predictors of EVB.5.The AUC of RPR,GPR,APRI and FIB-4 predicting EVB were 0.886,0.716,0.663 and 0.669,respectively.The RPR and GPR had moderate predictive value in predicting EVB;The predictive values of APRI and FIB-4 for EVB were low;The combination of RPR,GPR and FIB-4,which were predictors of EVB obtained by logistic regression analysis,could increase the AUC for predicting EVB to 0.927.Conclusion 1.The values of RPR,GPR,APRI and FIB-4 in patients with hepatitis B liver cirrhosis increase with the increase of Child classification.They are all positively correlated with Child classification,which can evaluate the liver reserve function of patients with hepatitis B liver cirrhosis.2.The RPR,GPR and FIB-4 are predictors of hepatitis B liver cirrhosis esophagogastric variceal bleeding.3.RPR and GPR have certain predictive values for hepatitis B cirrhosis esophagogastric variceal bleeding.The combination of RPR,GPR and FIB-4 can improve the predictive values of hepatitis B liver cirrhosis esophagogastric variceal bleeding. |
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