中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 3
Mar.  2024
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(3): 521-526

Establishment of a nomogram model for predicting liver cirrhosis with esophagogastric variceal bleeding based on aspartate aminotransferase-to-platelet ratio index and platelet-albumin-bilirubin score

DOI: 10.12449/JCH240314

  • Department of Infectious Diseases，The First Affiliated Hospital of Soochow University，Suzhou，Jiangsu 215000，China

Research funding:

National Major Science and Technology Special Project of the 13th Five-Year Plan Period (2017ZX10203201002-002);

Suzhou Health Youth Backbone Talent“National Tutorial System” Training Project (20190013990009);

Tianqing Liver Disease Research Foundation (TQGB20210134)

More Information
  • Corresponding author: CHEN Li， 756355153@qq.com （ORCID： 0000-0001-6278-5438）
  • Received Date: 2023-06-25
  • Accepted Date: 2023-07-31
  • Published Date: 2024-03-20
    Abstract
  •   Objective  To investigate the value of aspartate aminotransferase-to-platelet ratio index （APRI） and platelet-albumin-bilirubin （PALBI） score in predicting the risk of esophagogastric variceal bleeding in patients with liver cirrhosis.  Methods  A total of 119 patients with liver cirrhosis who were admitted to The First Affiliated Hospital of Soochow University from May 2021 and June 2022 were enrolled， and clinical data， routine blood test results， serum biochemistry， and coagulation test results were collected from all patients. According to the presence or absence of esophagogastric variceal bleeding， the patients were divided into non-bleeding group with 59 patients and bleeding group with 60 patients， and a comparative analysis was performed for the two groups. The independent samples t-test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-squared test or the Fisher’s exact test was used for comparison of categorical data between groups. The multivariate Logistic regression analysis was used to identify the independent risk factors for esophagogastric variceal bleeding in patients with liver cirrhosis and establish a nomogram predictive model.  Results  The male patients accounted for 75.00% in the bleeding group and 40.68% in the non-bleeding group， and there was a significant difference in sex composition between the two groups （χ2=14.384， P<0.001）. Chronic hepatitis B was the main etiology in both the bleeding group and the non-bleeding group （53.33% vs 38.98%）， and there was no significant difference in composition ratio between the two groups （χ2=2.464， P=0.116）. Compared with the non-bleeding group， the bleeding group had a significantly higher activity of AT-IIIA （t=3.329， P=0.001） and significantly lower levels of PLT， TBil， Ca， TC， and TT （all P<0.05）. There were significant differences in APRI and PALBI between the two groups （χ2=6.175 and 19.532， both P<0.05）. The binary logistic regression analysis showed that APRI （odds ratio ［OR］=0.309， 95% confidence interval ［CI］： 0.109‍ ‍—‍ ‍0.881， P=0.028）， PALBI （OR=7.667， 95%CI： 2.005‍ ‍—‍ ‍29.327， P=0.003）， Ca （OR=0.001， 95%CI： 0.000‍ ‍—‍ ‍0.141， P=0.007）， TC （OR=0.469， 95%CI： 0.226‍ ‍—‍ ‍0.973， P=0.042）， and TT （OR=0.599， 95%CI： 0.433‍ ‍—‍ ‍0.830， P=0.002） were independent influencing factors for esophagogastric variceal bleeding in liver cirrhosis. A nomogram model was established based on the above factors and had an index of concordance of 0.899 and a well-fitted calibration curve.  Conclusion  APRI and PALBI have a good value in predicting esophagogastric variceal bleeding in patients with liver cirrhosis， and the nomogram model established based on this study can predict the incidence rate of esophagogastric variceal bleeding in patients with liver cirrhosis.

     

    • FullText(HTML)
  • loading
    • References(18)
  • [1]
    Chinese Society of Hepatology, Chinese Medical Association. Chinese guidelines on the management of liver cirrhosis[J]. J Clin Hepatol, 2019, 35( 11): 2408- 2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006.

    中华医学会肝病学分会. 肝硬化诊治指南[J]. 临床肝胆病杂志, 2019, 35( 11): 2408- 2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006.
    [2]
    DENG H, QI X, PENG Y, et al. Diagnostic accuracy of APRI, AAR, FIB-4, FI, and King Scores for diagnosis of esophageal varices in liver cirrhosis: A retrospective study[J]. Med Sci Monit, 2015, 21: 3961- 3977. DOI: 10.12659/msm.895005.
    [3]
    WU X, ZHANG XJ, XUE Y, et al. Changes and clinical significance of blood antithrombin- and D-dimer levels in liver cirrhosis patients with gastrointestinal bleeding[J/CD]. Chin J Liver Dis: Electronic Edition, 2023, 15( 1): 56- 61. DOI: 10.3969/j.issn.1674-7380.2023.01.009.

    武幸, 张秀军, 薛源, 等. 肝硬化消化道出血患者血抗凝血酶Ⅲ和D-二聚体水平变化及临床意义[J/CD]. 中国肝脏病杂志(电子版), 2023, 15( 1): 56- 61. DOI: 10.3969/j.issn.1674-7380.2023.01.009.
    [4]
    LI DZ, LI J, GUO XL. Value of albumin-bilirubin score in predicting the prognosis of patients with liver cirrhosis and esophagogastric variceal bleeding[J]. J Clin Hepatol, 2021, 37( 5): 1085- 1090. DOI: 10.3969/j.issn.1001-5256.2021.05.022.

    李德钊, 李健, 郭晓林. 白蛋白-胆红素评分对肝硬化食管胃静脉曲张出血患者预后的预测价值[J]. 临床肝胆病杂志, 2021, 37( 5): 1085- 1090. DOI: 10.3969/j.issn.1001-5256.2021.05.022.
    [5]
    TANAKA K, TSUJI K, MATSUI T, et al. Potential of PALBI-T score as a prognostic model for hepatocellular carcinoma in alcoholic liver disease[J]. JGH Open, 2022, 6( 1): 36- 43. DOI: 10.1002/jgh3.12705.
    [6]
    GINÈS P, KRAG A, ABRALDES JG, et al. Liver cirrhosis[J]. Lancet, 2021, 398( 10308): 1359- 1376. DOI: 10.1016/S0140-6736(21)01374-X.
    [7]
    NIU SN, ZHAO JY, CHANG YF, et al. Application of monitored anesthesia care technique in emergency endoscopic treatment of liver cirrhosis patients with gastric varices bleeding[J/CD]. Chin J Liver Dis(Electronic Version), 2022, 14( 1): 67- 72. DOI: 10.3969/j.issn.1674-7380.2022.01.010.

    牛少宁, 赵金迎, 常宇飞, 等. 监护麻醉技术在急诊内镜下治疗肝硬化胃底静脉曲张破裂出血患者中的应用[J/CD]. 中国肝脏病杂志(电子版), 2022, 14( 1): 67- 72. DOI: 10.3969/j.issn.1674-7380.2022.01.010.
    [8]
    SINGAL AK, MATHURIN P. Diagnosis and treatment of alcohol-associated liver disease: A review[J]. JAMA, 2021, 326( 2): 165- 176. DOI: 10.1001/jama.2021.7683.
    [9]
    ZHANG XH, GUAN L, TIAN HY, et al. Risk factors and prevention of viral hepatitis-related hepatocellular carcinoma[J]. Front Oncol, 2021, 11: 686962. DOI: 10.3389/fonc.2021.686962.
    [10]
    MAI RY, WANG YY, BAI T, et al. Combination of ALBI and APRI to predict post-hepatectomy liver failure after liver resection for HBV-related HCC patients[J]. Cancer Manag Res, 2019, 11: 8799- 8806. DOI: 10.2147/CMAR.S213432.
    [11]
    WAI CT, GREENSON JK, FONTANA RJ, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C[J]. Hepatology, 2003, 38( 2): 518- 526. DOI: 10.1053/jhep.2003.50346.
    [12]
    XIAO GQ, YANG JY, YAN LN. Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis-4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: A systemic review and meta-analysis[J]. Hepatology, 2015, 61( 1): 292- 302. DOI: 10.1002/hep.27382.
    [13]
    SHRIVASTAVA R, SEN S, BANERJI D, et al. Assessment of non-invasive models for liver fibrosis in chronic hepatitis B virus related liver disease patients in resource limited settings[J]. Indian J Pathol Microbiol, 2013, 56( 3): 196- 199. DOI: 10.4103/0377-4929.120359.
    [14]
    IACOB DG, LUMINOS M, BENEA OE, et al. Liver fibrosis progression in a cohort of young HIV and HIV/HBV co-infected patients: A longitudinal study using non-invasive APRI and Fib-4 scores[J]. Front Med, 2022, 9: 888050. DOI: 10.3389/fmed.2022.888050.
    [15]
    KANG NL, RUAN QF, ZHANG DS, et al. Advantages of a novel model for predicting hepatic fibrosis in chronic hepatitis B virus carriers compared with APRI and FIB-4 scores[J]. J Clin Transl Hepatol, 2022, 10( 3): 412- 419. DOI: 10.14218/JCTH.2022.00098.
    [16]
    MORISHITA N, HIRAMATSU N, OZE T, et al. Liver stiffness measurement by acoustic radiation force impulse is useful in predicting the presence of esophageal varices or high-risk esophageal varices among patients with HCV-related cirrhosis[J]. J Gastroenterol, 2014, 49( 7): 1175- 1182. DOI: 10.1007/s00535-013-0877-z.
    [17]
    WANG JH, CHUAH SK, LU SN, et al. Transient elastography and simple blood markers in the diagnosis of esophageal varices for compensated patients with hepatitis B virus-related cirrhosis[J]. J Gastroenterol Hepatol, 2012, 27( 7): 1213- 1218. DOI: 10.1111/j.1440-1746.2012.07132.x.
    [18]
    YANG L, KAN QX, GAO J. Relationship between PALBI, MELD, INR and the prognosis of patients with liver cirrhosis combined with upper gastrointestinal hemorrhage and a multivariate study[J]. J Clin Exp Med, 2022, 21( 11): 1137- 1141. DOI: 10.3969/j.issn.1671-4695.2022.11.005.

    杨磊, 阚全香, 高杰. PALBI、MELD及INR值与肝硬化患者合并上消化道出血患者预后的关系及多因素研究[J]. 临床和实验医学杂志, 2022, 21( 11): 1137- 1141. DOI: 10.3969/j.issn.1671-4695.2022.11.005.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(5)  / Tables(2)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (315) PDF downloads(48) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return