Analysis Of The Methode In Evaluation Of Decompensated Cirrhotic Hypertension

Objectives: To research the relation between splenic PI? grading of EV and SAAG in evaluation of portal hypertension, to evaluate clinical application of the two methods of splenic PI?SAAG to predict EV in moderate or severe grade in cirrhosis patients, compare the accuracy and application of the two index. Methode: A cohort of patients with cirrhosis were studied, we measured splenic PI? SAAG? the grading of EV of these patients, Then we research the difference between splenic PI?SAAG and EVG; Receiver operating characrastic curve(ROC)and the area under the curve(AUC) were used to measure the prognostic ability of splenic PI ?SAAG to predict EV in moderate or severe grade.Result :the splenic PI between the groups of mild?moderate or severe grade of EV was different, P<0.05, respectively 1.25±0.09?1.39±0.23?1.64±0.37,spearman correlation coefficient between EV and splenic PI rs=0.53,P<0.01;The SAAG between the groups of mild?moderate or severe grade of EV was different,P<0.05, respectively 12.2±1.8g/L?16.1±2.2 g/L?17.7±2.5 g/L. spearman correlation coefficient between EV and SAAG rs=0.72, P<0.01, linear correlation coefficient between PI and SAAG r=0.16,P=0.4112. The AUC values generated by the ROC curves for splenic PI and SAAG were 0.765?0.898 in predicting moderate or severe grade of EV. Se and Sp were 0.68 and 0.87 for splenic PI,0.77 and 0.89 for SAAG, The cut-offs of splenic PI and SAAG were 1.35?14g/L in predicting moderate or severe grade of EV. Conclusion 1. splenic PI and SAAG are positively correlated with EVG, SAAG are more positively related with EVG than splenic PI; 2.splenic PI and SAAG are not correlated.3. For cirrhosis patients without ascites, splenic PI could evaluate the severity of portal hypertension and EV.4.For cirrhosis patients with ascites SAAG could evaluate the severity of portal hypertension and EV with better effectiveness,avoiding the risk of endoscopy.5.We could use splenic PI and SAAG to predict moderate or severe grade of EV.The cut-off for predicting moderate or severe grade of EV is 1.35 for splenic PI , 14g/L for SAAG.6.For cirrhosis patients without ascites we can use splenic PI to predict moderate or severe grade of EV. 7. For cirrhosis patients with ascites we can use SAAG to predict moderate or severe grade of EV,SAAG has higher accuracy in predicting moderate or severe grade of EV.8. When we use splenic PI to evaluate the severity of portal hypertension and EV ,the patient should not take vasoactive drugs and emictory; When we use SAAG to evaluate the severity of portal hypertension and EV, the samples of bood and urine must be tested in the same day to avoid interfering factors.