The Value Of FAST,APRI And Liver Stiffness Measure In The Risk Of Esophageal Variceal Bleeding In Patients With Hepatitis B Liver Cirrhosis

Objective:The purpose of this study was to analyze the predictive value of FibroScan-AST(FAST)score,Aspartateaminotransferase-to-Platelet Ratio Index(APRI)and Liver stiffness measure(LSM)in the risk of esophageal variceal bleeding in patients with hepatitis B cirrhosis by collecting blood routine,liver function and liver stiffness measure.Combined analysis of meaningful indicators to evaluate whether it can improve the predictive value of the risk of esophageal variceal bleeding in patients with hepatitis B cirrhosis.Methods:1.The clinical data of 147 patients with hepatitis B cirrhosis treated in thefirst affiliated Hospital of Gannan Medical University from October 2020 to October 2022 were collected retrospectively those accorded with The Guidelines for the prevention and treatment of chronic hepatitis B(2022version).The results of gastroscopy,platelet(PLT),aspartate aminotransferase(AST),liver stiffness measure(LSM),controlled attenuation parameter(CAP)were collected.The values of FAST,APRI and LSM were calculated,and the receiver operating characteristic curve(ROC curve)was drawn for themeaningful indicators through statistical analysis,and theirpredictive valuewas evaluated2.All the data involved in this study were statistically analyzed using SPSS21.0 software package.The measurement data are expressed in x±s,one-way ANOVAor T-test is used,the counting data are compared by X~2test,and the related risk factors are analyzed by Logistic regression analysis.Taking the diagnosis result of electronic gastroscope as the gold standard,the ROC curve was drawn and the Area Under The Receiver Opreating Characteristic Curve(AUC)was calculated to evaluate the predictive value of the index..The maximum value of Jordan index(sensitivity+specificity-1)was taken as thecut-offvalue tocalculate the sensitivity and specificity.Results:A total of 147 patients with hepatitis B cirrhosis were collected,including esophageal variceal bleeding high-risk group(n=74)and EVB low-risk group(n=73).The numerical values of LSM,APRI and FASTinesophageal variceal bleeding high risk group were 24.11±12.02(Kpa),1.49±1.19and 0.49±0.22 respectively.In esophageal variceal bleeding low risk group,LSM was 13.68±6.56(Kpa),APRI was 0.73±0.52,and FAST was 0.36±0.22,Analysised the numerical values,there were significant differences in LSM,APRI and FAST between the high risk group and the low risk group(P<0.001).;Fromthe area under the ROC curve,the AUC of LSM,APRI and FASTfor the highrisk of esophageal variceal bleeding were 0.808,0.792 and 0.673 respectively,And the AUC of LSM combined with APRI,FASTcombined with LSM,FASTcombined with APRI,FASTcombined with APRI and the combination of FAST,APRI and LSM for predicting the high risk of esophageal varicealbleeding were 0.846,0.798,0.793 and 0.883,respectively.Conclusion:1.FAST,APRI and liver hardness have high predictivevalue for high risk of esophagealvariceal bleeding in patients with hepatitis B cirrhosis.2.Thecombination of FAST,APRIand LSM can significantly improve the predictivevalue of highrisk of esophageal variceal bleeding inhepatitis B cirrhosis.