The Application Of Platelet Count,Spleen Thickness,and The Ratio Of Platelet Count To Spleen Thickness In Esophageal Varices Of Cirrhosis

Objective:To explore the clinical value of platelet count,spleen thickness,the ratio of platelet count to spleen thickness in esophageal varices of cirrhosis.Methods:To collect and screen 90 cirrhotic patients admitted in our hospital from January2018 to January 2020,according to the results of gastroscopy in our hospital were divided into 30 cases of non-oesophageal varices group and 60 cases of esophageal varices group.To compare the differences of platelet count,spleen thickness,the ratio of platelet count to spleen thickness between the two groups,the predictive value of esophageal varices was analyzed by receiver operating characteristic(ROC);then the esophageal varices goup were divided into mild-medium group and severe group according to the degree of varices,compare the differences of platelet count,spleen thickness,the ratio of platelet count to spleen thickness between the two groups,the predictive value of esophageal varices was analyzed by ROC.Results:In this study,there were no statistically significant differences in age,gende r,and causes of cirrhosis between the non-esophageal varices group and the esop hageal varices group,and between the mild to moderate esophageal varices grou p and the severe esophageal varices group(P > 0.05).No esophageal varices gro up of platelet count(124.00±44.01 mm),thickness of spleen(35.10±3.23),platele t count/spleen thickness(3.63±1.50)and the esophageal varices group of platelet count(76.53±26.38 mm),spleen thickness(47.73±11.08),platelet count/spleen thickness(1.78±0.11)difference was statistically significant(P < 0.05),the differenc e of the index draw ROC curve analysis found that the platelet count prediction area under the curve of esophageal varices is 0.809,(95%CI :0.7141~0.903);the optimal threshold value was 100.05,the corresponding sensitivity was 0.567,and the specificity was 0.1.The area under the curve of esophageal varices predicted by spleen thickness was 0.903,(95%CI:0.844~0.962);the optimal threshold value was 39.5,the corresponding sensitivity was 0.733 and the specificity was 0.1.The ratio of platelet count to spleen thickness predicted the area under the curve of esophageal varices was 0.859,(95%CI :0.781~0.936);the optimal threshold was 2.235,and the corresponding sensitivity was 0.867 and the specificity was 0.333.mild-medium esophageal varices group of platelet count(93.8±18.21 mm),spleen thickness(39.37±3.71),platelet count/spleen thickness(2.41±0.62)and severe es ophageal varices group of platelet count(59.27±21.62 mm),spleen thickness(55.8±10.07),platelet count/spleen thickness(1.13±0.56)difference was statistically si gnificant(P < 0.05),the difference of the index to draw ROC curve analysis fo und that,The area under the curve of severe esophageal varices predicted by plat elet count was 0.882,(95%CI:0.798~0.967);the optimal threshold was 71,the co rresponding sensitivity was 0.933 and the specificity was 0.267.and the area und er the curve predicted by spleen thickness was 0.938,(95%CI:0.881~0.995);the o ptimal threshold value was 44.5,the corresponding sensitivity was 0.867 and the specificity was 0.133.The ratio of platelet count to spleen thickness predicted th e area under the curve of severe esophageal varices was 0.931,(95%CI:0.869~0.907);the optimal threshold value was 1.615,and the corresponding sensitivity w as 0.933 and specificity was 0.67.Conclusion:1.Platelet count,spleen thickness and the ratio of platelet count to spleen thickness can predict esophageal varices and severe esophageal varices.2.The ratio of platelet count to spleen thickness is more sensitive and specific to predicting esophageal varices and severe esophageal varices than that of individualindex.